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Current Oncology
Volume 28
Issue 6
10.3390/curroncol28060418
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Article

Association between Ureteral Clamping Time and Acute Kidney Injury during Robot-Assisted Radical Cystectomy

by
Yudai Ishiyama
1,2,
Tsunenori Kondo
1,*,
Hiroki Ishihara
1,
Kazuhiko Yoshida
2,
Junpei Iizuka
2,
Kazunari Tanabe
2 and
Toshio Takagi
2
1
Department of Urology, Tokyo Women’s Medical University Medical Center East, 2-1-10 Nishiogu, Arakawa-ku, Tokyo 1168567, Japan
2
Department of Urology, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 1620054, Japan
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2021, 28(6), 4986-4997; https://doi.org/10.3390/curroncol28060418
Submission received: 31 October 2021 / Revised: 20 November 2021 / Accepted: 26 November 2021 / Published: 29 November 2021
(This article belongs to the Special Issue Totally Intracorporeal Urinary Diversion after Robot-Assisted Radical Cystectomy for Muscle-Invasive Bladder Cancer)
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Abstract

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.
Keywords: acute kidney injury; robotic surgery; bladder cancer; radical cystectomy acute kidney injury; robotic surgery; bladder cancer; radical cystectomy

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MDPI and ACS Style

Ishiyama, Y.; Kondo, T.; Ishihara, H.; Yoshida, K.; Iizuka, J.; Tanabe, K.; Takagi, T. Association between Ureteral Clamping Time and Acute Kidney Injury during Robot-Assisted Radical Cystectomy. Curr. Oncol. 2021, 28, 4986-4997. https://doi.org/10.3390/curroncol28060418

AMA Style

Ishiyama Y, Kondo T, Ishihara H, Yoshida K, Iizuka J, Tanabe K, Takagi T. Association between Ureteral Clamping Time and Acute Kidney Injury during Robot-Assisted Radical Cystectomy. Current Oncology. 2021; 28(6):4986-4997. https://doi.org/10.3390/curroncol28060418

Chicago/Turabian Style

Ishiyama, Yudai, Tsunenori Kondo, Hiroki Ishihara, Kazuhiko Yoshida, Junpei Iizuka, Kazunari Tanabe, and Toshio Takagi. 2021. "Association between Ureteral Clamping Time and Acute Kidney Injury during Robot-Assisted Radical Cystectomy" Current Oncology 28, no. 6: 4986-4997. https://doi.org/10.3390/curroncol28060418

APA Style

Ishiyama, Y., Kondo, T., Ishihara, H., Yoshida, K., Iizuka, J., Tanabe, K., & Takagi, T. (2021). Association between Ureteral Clamping Time and Acute Kidney Injury during Robot-Assisted Radical Cystectomy. Current Oncology, 28(6), 4986-4997. https://doi.org/10.3390/curroncol28060418

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