Urologia internationalis · 2026
Intraoperative Doppler Verification of Arterial Occlusion in Minimally Invasive Renal Resection.
СтатьяНазвание и аннотация: Перевод в очереди
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Veselá Adriena Bartoš, Kolář Jiří, Sedláčková Hana, Pitra Tomáš, Stránský Petr, Ürge Tomáš, Trávníček Ivan, Ferda Jiří, Pivovarčíková Kristýna, Hora Milan
Аннотация
INTRODUCTION: Doppler ultrasonography (DUSG) enables intraoperative assessment of renal perfusion during partial nephrectomy. This study evaluated the feasibility of DUSG and compared its outcomes with indocyanine green (ICG) fluorescence imaging and a control group (CG) without intraoperative perfusion imaging.
METHODS: We retrospectively analyzed 426 patients undergoing minimally invasive partial nephrectomy between 2018 and July 2025. Ischemia verification was performed using DUSG in 174 patients (41%) and ICG in 29 patients (7%). The CG included 223 patients (52%). Selection of imaging modality depended on the surgeon's preference and intraoperative findings. Perioperative, oncological, and functional outcomes were analyzed using one-way analysis of variance and chi-square tests.
RESULTS: No significant differences were observed in tumor size, BMI, warm ischemia time, blood loss, RENAL score, or complication severity assessed by the Clavien-Dindo classification. Selective clamping and clamp adjustment were significantly more frequent in the DUSG and ICG groups compared with controls (both p < 0.001). Positive surgical margin rates were low and comparable between groups.
CONCLUSION: Both DUSG and ICG represent safe and effective methods for ischemia verification; however, DUSG offers the advantages of lower cost, wider availability, and no risk of contrast-related adverse reactions, making it a practical option for routine clinical use.
METHODS: We retrospectively analyzed 426 patients undergoing minimally invasive partial nephrectomy between 2018 and July 2025. Ischemia verification was performed using DUSG in 174 patients (41%) and ICG in 29 patients (7%). The CG included 223 patients (52%). Selection of imaging modality depended on the surgeon's preference and intraoperative findings. Perioperative, oncological, and functional outcomes were analyzed using one-way analysis of variance and chi-square tests.
RESULTS: No significant differences were observed in tumor size, BMI, warm ischemia time, blood loss, RENAL score, or complication severity assessed by the Clavien-Dindo classification. Selective clamping and clamp adjustment were significantly more frequent in the DUSG and ICG groups compared with controls (both p < 0.001). Positive surgical margin rates were low and comparable between groups.
CONCLUSION: Both DUSG and ICG represent safe and effective methods for ischemia verification; however, DUSG offers the advantages of lower cost, wider availability, and no risk of contrast-related adverse reactions, making it a practical option for routine clinical use.