Cancer - Kidney(구연) International Session I (I-01) Rm. 202 10월 31일(목) 15:00-16:00 Partial nephrectomy using Zero Vs Warm ischemia :Effect on renal function preservation over a long term follow up (1)department of urology , Imam Abdulrahman bin Faisal University ,Dammam Saudi arabia. (2)Department of urology , Yonsei University ,Seoul South korea Hatem Althubiany(1) , Hussein gossadi(2), Koon ho Rha(2) ,Seung Hwan Lee(2) . Purpose: The aim of the study is to retrospectively review the cases of partial nephrectomy done at severance hospital (Yonsei university), and to analyze the difference between zero ischemia Vs warm ischemia ( both complete and selective arterial clamping) , comparing renal function change during long term follow up and the estimated blood loss . Method: We have retrospectively reviewed patients who underwent partial nephrectomy both robotic assisted and laparoscopic, in the period between January 2008 to June 2017, total patients number was 448. We included Patients who have T1-T2a renal tumor with at least 2 years of follow up , no diabetes, hypertension, conversion to radical nephrectomy or solitary kidney. 207 patients were included in our study, we compared the 3 groups in intraoperative estimated blood loss and the GFR using MDRD formula pre-operatively, at one month, at one year and two years using one way ANOVA test. Result: 207 patients were divided into 3 groups, G1: patients with zero ischemia(n=50,24.1%), G2: patient with complete hilar clamping (n=51,24.6%) and G3:patients with selective arterial clamping (n=106,51.2%). Mean age for each group was (49.86 vs 48.29 vs 48.79) respectively. Tumor size was comparable between all the groups s (G1:2.27 vs G2:3.1 vs G3:3.2) cm. Estimated blood loss was comparable between the groups (G1:346 vs G2:404 vs G3:301) P=0.25 The Mean for Preoperative GFR for the 3 groups was (G1=83.44 vs G2=83.23 vs G3=83.3) P= 0.89, at one month post-op GFR was (G1=82.7 vs G2=79.1 vs G3=77.4) P=0.04 showing significant difference. However, at one year the difference was insignificant (G1=83.1 vs G2=78.8 vs G3=80) With P=0.43 and it continues to be the case at two years GFR comparison (G1=83.18 vs G2=79.32 vs G3=80.5) P=0.30 Conclusion: The use of zero ischemia partial nephrectomy for T1 renal tumor is becoming appealing option for urologists in selected cases , as it showed in some study that it is safe and improves renal function preservation , especially in short term follow up , however , in our study a long term follow up comparison was made against other form of worm ischemia , and it showed no significant advantage over them , bleeding during operation could have an adverse effect on the kidney function parallel to the warm ischemia , zero ischemia partial nephrectomy is a feasible option in selected cases, and other long term study to evaluate the effect on renal function is needed. keywords : Renal Cancer , Partial nephrectomy , Zero ischemia time,renal function