ヨシダ　カズヒコ   吉田　一彦    所属   医学部 医学科（東京女子医科大学病院）    職種   講師
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