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Title: In-vitro renal shrinkage after hypertonic saline perfusion for organ removal during Laparoscopic nephrectomy
Authors: Andreoni, Cassio
Araujo, Mardhen B.
Bomfim, Alexandre C.
Manzano, Joao P.
Silva, Flavio D.
Scapulatempo-Neto, Cristovam
Fagundes, Djalma J.
Poli-De-Figueiredo, Luis
Ortiz, Valdemar
Universidade Federal de São Paulo (UNIFESP)
Issue Date: 1-Aug-2007
Publisher: Mary Ann Liebert Inc
Citation: Journal of Endourology. New Rochelle: Mary Ann Liebert Inc, v. 21, n. 8, p. 891-896, 2007.
Abstract: Background and Purpose: To evaluate the possibility of shrinking the kidney by perfusion with hypertonic solution to facilitate organ removal in laparoscopic surgery.Materials and Methods: After 18 open nephrectomies (ONs) in 9 pigs, one of four saline solutions ( 5%, 7.5%, 10%, and 15%) was infused through a catheter into the renal artery for 5 minutes in four kidneys each. the volumes and weights of the kidneys were measured before and after renal perfusion; the kidneys were then sent for histologic evaluation. Eight ONs were performed, and the kidneys were removed from the abdominal cavity in a plastic bag in order to mimic organ entrapment during laparoscopy. the kidneys were perfused with hypertonic solution and were again put in a plastic bag and removed from the same animal's abdomen through another incision. the incisions were measured with calipers before and after extraction of the unperfused and perfused organs.Results: the kidneys that underwent perfusion with 5% saline had the greatest decrease in both weight and volume, an average of 16% and 17.8%, respectively. the average incision needed for extraction of unperfused kidneys was 44.9 mm ( range 40 - 58 mm), whereas the mean size of the incision needed to remove perfused kidneys was 26.6 mm ( range 20 - 30 mm) ( P < 0.001). the relative reduction in the necessary incision size therefore was 44.3% ( range 33.3% - 55%).Conclusion: Perfusion with 5% saline is able to shrink the kidney volume slightly with mild histologic changes. in the pig, it is possible to decrease the renal incision necessary for kidney removal by 44% using this method.
ISSN: 0892-7790
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