イシハラ　ヒロキ   Ishihara Hiroki   石原　弘喜    所属   医学部 医学科（東京女子医科大学病院）    職種   助教
論文種別	原著
言語種別	英語
査読の有無	査読あり
招待の有無	招待あり
表題	Association between ureteral clamping time and acute kidney injury during robot-assisted radical cystectomy.
掲載誌名	正式名：Current oncology. ISSNコード：11980052/17187729
掲載区分	国外
巻・号・頁	28(6),pp.4986-4997
著者・共著者	ISHIYAMA Yudai†, KONDO Tsunenori*, ISHIHARA Hiroki, YOSHIDA Kazuhiko, IIZUKA Junpei, TANABE Kazunari, TAKAGI Toshio
発行年月	2021/11
概要	Robot-assisted radical cystectomy (RARC) is replacing open radical cystectomy (ORC) and requires clamping of the ureters, resulting in a predisposition to postrenal acute kidney injury (AKI). We investigated the association between ureteral clamping or its duration and acute/chronic postoperative kidney function. Patients who underwent radical cystectomy (robotic or open) at two tertiary institutions during 2002-2021 were retrospectively enrolled. In those who underwent RARC, the maximum postoperative percentage serum creatinine level (%sCre) change was plotted against ureteral clamping duration. They were divided into two groups using the median clamping time (210 min), and the maximum %sCre change and percentage estimated glomerular filtration rate (%eGFR) change at 3-6 months (chronic) were compared between the ORC (no clamp), RARC < 210, and RARC ≥ 210 groups. In 44 RARC patients, a weak correlation was observed between the duration of ureteral clamping and %Cre change (R2 = 0.22, p = 0.001). Baseline serum creatinine levels were comparable between the groups. However, %sCre change was significantly larger in the RARC ≥ 210 group (N = 17, +32.1%) than those in the RARC < 210 (N = 27, +6.1%) and ORC (N = 76, +9.5%) groups (both, p < 0.001). Chronic %eGFR change was comparable between the groups. Longer clamping of the ureter during RARC may precipitate AKI; therefore, the clamping duration should be minimized.
DOI	10.3390/curroncol28060418
PMID	34940057