[Evaluation of 99mTc-DTPA scyntygraphy of the relative degree of renal dysfunction after surgical removal of kidney tumor].
ABSTRACT In nephron sparing surgery (NSS) procedures the most important is oncological outcome and also the preservation of maximum renal function. Renal scyntygraphy using 99mTc-DTPA allows for assessment of renal function and its changes after surgery because of tumor.
To assess the loss of kidney function operated using 99mTc-DTPA scyntygraphy, depending on the location of the tumor, type of growth, and time of warm ischemia of the operated kidney.
Renal scyntygraphy was performed in 30 patients who underwent NSS procedures for renal cortical tumors of its diameter of about 3.2 cm (range: 2.5-4.1 cm) before surgery and after surgery at an average of 3.8 months (range: 2.3-5.4 months). All patients were stratified according to time of warm ischemia (up to and above 10 mines), type of tumor growth (endo- and egzophytic) and tumor location (upper, middle and lower pole).
The relative loss of kidney function operated depending on the type of kidney tumor growth when egzophytic and endophytic was amounted to 16% (range: 12-22%) and 29% (range: 24-46%) respectively (p < 0.01), in contrast depending on the location in the upper, middle and lower pole of the kidney 24% (range: 12-36%), 31% (range: 26-46%) and 25% (range: 15-38%), respectively (p < 0.05) Depending on the time of warm ischemia for up to and above 10 mines a relative loss of kidney function of surgery was set at 21% (range: 12-24%) and 31% (range: 29-46%), respectively (p < 0.1).
The results of this study suggest that the loss of kidney function after NSS procedures for renal cortical tumor is the largest in the middle field of tumor endophytic growth where, during the operation the time of warm ischemia is the longest. Tumors of this type should be operating in the centers performing these procedures on a routine basis.