THE FIRST EXPERIENCE OF NOVEL CLAMP TO PERFORM OPEN PARTIAL NEPHRECTOMY UNDER REGIONAL ISCHEMIA FOR THE TUMORS LOCALIZED IN THE MIDDLE PART OF THE KIDNEY AS A GOOD ALTERNATIVE FOR THE TRADITIONAL METHOD

AIM OF STUDY was to report about the novel type of partial nephrectomy performed with the help of special parenchymal clamp for tumors localized in the medial part of the kidney and to show the benefits of regional ischemia over traditional vascular clamping in the terms of early functional outcomes. PATIENTS AND METHODS. Three cases of the open partial nephrectomy with the novel parenchymal clamp were explored. Among the patients there was a man with a solitary kidney. The incision was made under the XIIth rib. All the tumors were localized in the middle part of the kidney laterally. The novel clamp with the semilunar branches was placed around the tumor and 2 cm proximally. The vascular pedicle was not clamped. The procedure then was performed in the bloodless field, after that the kidney wound was sutured. RESULTS. The operation time was 90, 115 and 120 min. Time of local ischemia was 17, 18 and 21 min. There were no complications. In two cases serum creatinine level increased from 0,088 and 0,101 to 0,095 and 0,103 mmol/l respectively 24 hours after the procedure. In the patient with solitary kidney serum creatinine level increased from 0,112 to 0,130 mmol/l. CONCLUSIONS. Regional ischemia provides better early functional outcomes during open partial nephrectomy than traditional total ischemia. The novel clamp helps to reduce the risks and difficulty of the procedure.

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