Skip to main content
Erschienen in: Clinical and Experimental Nephrology 5/2009

01.10.2009 | Original Article

Microwave tissue coagulator induces renal apoptotic damage to preserved normal renal tissue following partial nephrectomy

verfasst von: Masayuki Nanri, Kazuma Udo, Maki Kawasaki, Yuji Tokuda, Chisato Fujiyama, Jiro Uozumi, Shuji Toda

Erschienen in: Clinical and Experimental Nephrology | Ausgabe 5/2009

Einloggen, um Zugang zu erhalten

Abstract

Background

We assessed the extent of apoptotic damage induced by the microwave tissue coagulator (MTC) in the preserved normal renal tissue following partial nephrectomy.

Methods

Eleven patients who underwent nonischemic partial nephrectomy with MTC (group M) were enrolled in this study. The other 11 patients who underwent cold-ischemic partial nephrectomy without the use of MTC were enrolled as controls (group C). There were no significant differences in tumor size or age between the two groups. Renal damage was evaluated by counting apoptotic cells in the normal renal tissue surrounding the tumor tissue. Immunohistochemical staining with single-stranded DNA was carried out to investigate the apoptotic cells.

Results

The number of apoptotic cells in group M ranged from 275 to 508 per 1,000 cells, with a median value of 421. The number in group C ranged from 122 to 466 per 1,000 cells with a median value of 286. The number of apoptotic cells in group M was significantly greater than that in group C (p = 0.006). Blood loss in group C was significantly greater than that in group M (p < 0.0001).

Conclusions

This study points out that renal damage induced by the use of MTC comprises not only necrosis but also apoptotic change. Although MTC is useful for controlling renal parenchymal bleeding during partial nephrectomy, we must consider that renal apoptotic damage caused by the MTC may spread beyond the coagulated necrosis area.
Literatur
1.
Zurück zum Zitat Novick AC. Nephron-sparing surgery for renal cell carcinoma. Annu Rev Med. 2002;53:393–407.CrossRefPubMed Novick AC. Nephron-sparing surgery for renal cell carcinoma. Annu Rev Med. 2002;53:393–407.CrossRefPubMed
2.
Zurück zum Zitat Tabuse K. A new operative procedure of hepatic surgery using a microwave tissue coagulator. Nippon Geka Hokan. 1979;48:160–72.PubMed Tabuse K. A new operative procedure of hepatic surgery using a microwave tissue coagulator. Nippon Geka Hokan. 1979;48:160–72.PubMed
3.
Zurück zum Zitat Hirao Y, Fujimoto K, Yoshii M, Tanaka N, Hayashi Y, Momose H, et al. Non-ischemic nephron-sparing surgery for renal cell carcinoma: complete tumor enucleation using a microwave tissue coagulator. Jpn J Clin Oncol. 2002;32:95–102.CrossRefPubMed Hirao Y, Fujimoto K, Yoshii M, Tanaka N, Hayashi Y, Momose H, et al. Non-ischemic nephron-sparing surgery for renal cell carcinoma: complete tumor enucleation using a microwave tissue coagulator. Jpn J Clin Oncol. 2002;32:95–102.CrossRefPubMed
4.
Zurück zum Zitat Yoshimura K, Okubo K, Ichioka K, Terada N, Matusta Y, Arai Y. Laparoscopic partial nephrectomy with a microwave tissue coagulator for small renal tumor. J Urol. 2001;165:1893–6.CrossRefPubMed Yoshimura K, Okubo K, Ichioka K, Terada N, Matusta Y, Arai Y. Laparoscopic partial nephrectomy with a microwave tissue coagulator for small renal tumor. J Urol. 2001;165:1893–6.CrossRefPubMed
5.
Zurück zum Zitat Muraki J, Schwalb DM, Cord J, Armenakas N, Addonizio JC, Nagamatus GR, et al. Application of microwave tissue coagulation in partial nephrectomy. Urology. 1991;37:282–7.CrossRefPubMed Muraki J, Schwalb DM, Cord J, Armenakas N, Addonizio JC, Nagamatus GR, et al. Application of microwave tissue coagulation in partial nephrectomy. Urology. 1991;37:282–7.CrossRefPubMed
6.
Zurück zum Zitat Kageyama Y, Kihara K, Yokoyama M, Sakai Y, Koga F, Saito K, et al. Endoscopic minilaparotomy partial nephrectomy for solitary renal cell carcinoma smaller than 4 cm. Jpn J Clin Oncol. 2002;32:417–21.CrossRefPubMed Kageyama Y, Kihara K, Yokoyama M, Sakai Y, Koga F, Saito K, et al. Endoscopic minilaparotomy partial nephrectomy for solitary renal cell carcinoma smaller than 4 cm. Jpn J Clin Oncol. 2002;32:417–21.CrossRefPubMed
7.
Zurück zum Zitat Murota T, Kawakita M, Oguchi N, Shimada O, Danno S, Fujita I, et al. Retroperitoneoscopic partial nephrectomy using microwave coagulation for small renal tumors. Eur Urol. 2002;41:540–5.CrossRefPubMed Murota T, Kawakita M, Oguchi N, Shimada O, Danno S, Fujita I, et al. Retroperitoneoscopic partial nephrectomy using microwave coagulation for small renal tumors. Eur Urol. 2002;41:540–5.CrossRefPubMed
8.
Zurück zum Zitat Furuya Y, Tsuchida T, Takihana Y, Araki I, Tanabe N, Takeda M. Retroperitoneoscopic nephron-sparing surgery of renal tumor using a microwave tissue coagulator without renal ischemia: comparison with open procedure. J Endourol. 2003;17:53–8.CrossRefPubMed Furuya Y, Tsuchida T, Takihana Y, Araki I, Tanabe N, Takeda M. Retroperitoneoscopic nephron-sparing surgery of renal tumor using a microwave tissue coagulator without renal ischemia: comparison with open procedure. J Endourol. 2003;17:53–8.CrossRefPubMed
9.
Zurück zum Zitat Terai A, Ito N, Yoshimura K, Ichioka K, Kamoto T, Arai Y, et al. Laparoscopic partial nephrectomy using microwave tissue coagulator for small renal tumors: usefulness and complications. Eur Urol. 2004;45:744–8.CrossRefPubMed Terai A, Ito N, Yoshimura K, Ichioka K, Kamoto T, Arai Y, et al. Laparoscopic partial nephrectomy using microwave tissue coagulator for small renal tumors: usefulness and complications. Eur Urol. 2004;45:744–8.CrossRefPubMed
10.
Zurück zum Zitat Tanaka N, Fujimoto K, Tani M, Yoshii M, Yoshida K, Hirao Y, et al. Prediction of postoperative renal function by preoperative serum creatinine level and three-dimensional diagnostic image reconstruction in patients with renal cell carcinoma. Urology. 2004;64:904–8.CrossRefPubMed Tanaka N, Fujimoto K, Tani M, Yoshii M, Yoshida K, Hirao Y, et al. Prediction of postoperative renal function by preoperative serum creatinine level and three-dimensional diagnostic image reconstruction in patients with renal cell carcinoma. Urology. 2004;64:904–8.CrossRefPubMed
11.
Zurück zum Zitat Kondo T, Nakazawa H, Ito F, Onitsuka O, Ryoji O, Yago R, et al. Impact of arterial occlusion during partial nephrectomy on residual renal function: an evaluation with 99m technetium-dimercatosuccinic acid scintigraphy. Int J Urol. 2002;9:435–40.CrossRefPubMed Kondo T, Nakazawa H, Ito F, Onitsuka O, Ryoji O, Yago R, et al. Impact of arterial occlusion during partial nephrectomy on residual renal function: an evaluation with 99m technetium-dimercatosuccinic acid scintigraphy. Int J Urol. 2002;9:435–40.CrossRefPubMed
12.
13.
Zurück zum Zitat Wolfs T, Vries B, Walter S, Peutz-Kootstra C, Heurn L, Oosterhol G, et al. Apoptotic cell death is initiated during normothermic ischemia in human kidneys. Am J Transplant. 2005;5:68–75.CrossRefPubMed Wolfs T, Vries B, Walter S, Peutz-Kootstra C, Heurn L, Oosterhol G, et al. Apoptotic cell death is initiated during normothermic ischemia in human kidneys. Am J Transplant. 2005;5:68–75.CrossRefPubMed
14.
Zurück zum Zitat Satoh Y, Uozumi J, Nanri M, Nakajima K, Kanou T, Tokuda Y, et al. Renal-tissue damage induced by laparoscopic partial nephrectomy using microwave tissue coagulator. J Endourol. 2005;19:818–22.CrossRefPubMed Satoh Y, Uozumi J, Nanri M, Nakajima K, Kanou T, Tokuda Y, et al. Renal-tissue damage induced by laparoscopic partial nephrectomy using microwave tissue coagulator. J Endourol. 2005;19:818–22.CrossRefPubMed
Metadaten
Titel
Microwave tissue coagulator induces renal apoptotic damage to preserved normal renal tissue following partial nephrectomy
verfasst von
Masayuki Nanri
Kazuma Udo
Maki Kawasaki
Yuji Tokuda
Chisato Fujiyama
Jiro Uozumi
Shuji Toda
Publikationsdatum
01.10.2009
Verlag
Springer Japan
Erschienen in
Clinical and Experimental Nephrology / Ausgabe 5/2009
Print ISSN: 1342-1751
Elektronische ISSN: 1437-7799
DOI
https://doi.org/10.1007/s10157-009-0180-8

Weitere Artikel der Ausgabe 5/2009

Clinical and Experimental Nephrology 5/2009 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.