ABSTRACT
Objective
To evaluate renal damage after off-clamp partial nephrectomy (PN) using a novel surgical
device, piezo actuator-driven pulsed water jet (ADPJ) system.
Methods
Sprague-Dawley rats were divided into 4 groups and subjected to sham operation, off-clamp
PN by the piezo ADPJ system, radio knife, and soft coagulation, which have been used
as thermal coagulation devices. Urine and blood samples were collected, and residual
kidneys were harvested at 1, 7, 14, 30, and 90 days after PN. Serum blood urea nitrogen,
creatinine, and urinary and serum kidney injury molecule-1 KIM-1 levels were measured.
Morphological features and the extent of renal ischemia of resection surfaces were
evaluated by hematoxylin-eosin staining and immunostaining using antibodies to 1-methyladenosine,
respectively. In addition, the expression levels of KIM-1 mRNA extracted from each
resection surface were analyzed by quantitative real-time reverse transcription polymerase
chain reaction.
Results
Serum blood urea nitrogen and creatinine were significantly lower with the piezo ADPJ
system than with soft coagulation. Urinary and serum KIM-1 levels were also significantly
decreased with the ADPJ. The extent of 1-methyladenosine immunostaining was significantly
less with the ADPJ than with thermal coagulation devices. The expression levels of
KIM-1 mRNA were also lower in the ADPJ system group.
Conclusion
The piezo ADPJ system might attenuate renal damage after off-clamp PN.
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Article Info
Publication History
Published online: October 22, 2018
Accepted:
October 2,
2018
Received in revised form:
September 27,
2018
Received:
May 17,
2018
Footnotes
Funding Support: This work was supported in part by the Translational Research Network Program from the Japanese Ministry of Education, Culture, Sports, Science, and Technology (MEXT), the Japanese Foundation for Research and Promotion of Endoscopy Grant, Grants-in-Aid for Scientific Research from the Japan Society for the Promotion of Science(15H01707, 18H04157, 26282116, 15H04945, 26462196, 26462197, 24592049, 26461297, 15K10353, 15K10572), the Miyagi Prefecture Kidney Association Grant, and the Clinical Research Promotion Program for Young Investigators of Tohoku University Hospital.
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Copyright
© 2018 Elsevier Inc. All rights reserved.
