Turkish Journal of Urology
UROONCOLOGY - Systematic Review

Surgical and Functional Outcomes of Artery Only Versus Artery and Vein Clamping in Patients Undergoing Partial Nephrectomy: A Systematic Review and Meta-Analysis

1.

Department of Urology, The James Cook University Hospital, Middlesbrough, UK

2.

Department of Urology, Frimley Park Hospital, Camberely, UK

3.

Department of Urology, Wythenshawe Hospital, Manchester, UK

4.

Department of Urology, University Hospitals Birmingham, Birmingham, UK

Turk J Urol 2022; 48: 180-195
DOI: 10.5152/tud.2022.22009
Read: 406 Downloads: 106 Published: 01 May 2022

Clamping of renal vessels during partial nephrectomy is usually performed to improve the visualization of tumor margins. However, clamping of renal vessels has been associated with detrimental effects on renal function after surgery. This study aimed to compare artery only versus artery and vein clamping as regards the surgical and functional outcomes in patients undergoing partial nephrectomy. The literature was searched for English published studies from January 1, 2000 to August 7, 2021. The search included MEDLINE/ PubMed, Cochrane Library, Scopus, Web of Science, Google Scholar, and ProQuest, using the terms {“par- tial nephrectomy”} OR {“nephron-sparing surgery”} AND {“renal artery and vein clamping} AND {“renal artery only clamping}. Nine studies were included. Meta-analysis showed the artery only clamping grouphad a significantly less percentage of change in glomerular filtration rate at last follow-up (standardizedmean difference: −0.42 [95% CI: −0.70, −0.13], P = .004) as well as a rate of postoperative complications(odds ratio: 0.64 [95% CI: 0.41, 0.98], P = .04). However, no significant difference was observed regarding the development of chronic kidney disease. There was no significant difference regarding the warm ischemiatime, blood loss, or positive surgical margin. Artery only clamping has a comparable safety to artery and vein clamping and may produce a renoprotective effect. Due to limitations of the included studies, the conduction of large-size randomized clinical trials with a long duration of follow-up is required before recommending the replacement of artery and vein clamping with artery only clamping during partial nephrectomy.

Cite this article as: Deb AA, Agag A, Naushad N, Serag H. Surgical and functional outcomes of artery only versus artery and vein clamping in patients undergoing partial nephrectomy: A systematic review and meta-analysis. Turk J Urol. 2022;48(3):180-195.

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