Romanian Journal of Medical Practice (Sep 2017)
Pringle maneuver during open partial nephrectomy for renal tumors
Introduction. Sparing kidney tissue is important because studies show that patients who have their entire kidney removed are more likely to suffer from chronic kidney disease after surgery than patients who received a kidney-sparing partial nephrectomy. The aim of study is to show the effectives of Pringle maneuver for clamping renal pedicle in order to minimize warm ischemia during open partial nephrectomy. Material and method. We retrospectively analyzed 34 patients diagnosed with cT1 renal tumors between 2012 and 2016 and underwent open partial nephrectomy in Sibiu Urology Department. During the surgery we perform clamping of renal pedicle with Satinsky clamp or with the Pringle maneuver. We analyzed the flowing parameters: operation time, blood loss, clamping time and serum creatinine before and after the surgery. Results. The mean age of patient with partial nephrectomy was 58.7±14.7 years, with 56.7±12.4 years for Satinsky group and 60.5±11.6 for Pringle group. The average duration for partial nephrectomy was 94.8±19.4 minutes. Average blood loss for all surgeries was 220±30 ml. Conclusion. Pringle maneuver is a safe and effective method with low intra and postoperative complications during open partial nephrectomy, having a good control of the renal pedicle with reduced ischemia. Is a feasible method of choice in renal tumor pathology on a single congenital or surgical kidney, mediorenal tumors or near the sinus and multifocal tumors.