Clinical Oncology: Outcomes & Complications

Moderated Poster Session

MP18-6 - Intraoperative mannitol during partial nephrectomy does not benefit patients with diminished renal functional reserve at baseline

Saturday, September 22
10:00 AM - 12:00 PM
Location: Room 253

Introduction & Objective : To assess if intraoperative mannitol during partial nephrectomy (PN) provides clinical benefit to patients with impaired kidney function at baseline (eGFR< 60 mL/min/1.73 m²).


Methods : A retrospective analysis was performed using an institutional renal cancer database. Patients were divided into 2 groups: mannitol (+) eGFR < 60 and mannitol (-) eGFR < 60. Patients with baseline eGFR > 60 and those lacking at least one follow-up (f/u) creatinine measurement were excluded. The outcomes measured were eGFR change and CKD upstaging at two postoperative f/u times. Covariates in this study included first and second f/u periods (weeks), ischemia time (minutes), blood loss (ml), intravenous fluids given (ml), tumor size (cm), and age (years). Mann-Whitney U tests were used to determine if eGFR changes and covariates differed amongst groups. Differences in CKD upstaging were evaluated with chi-squared analysis.


Results : 157 total patients had sufficient f/u of which 24 had a baseline eGFR < 60 (CKD III-V) and met inclusion criteria. The average eGFR of these patients was 51.28 (12.48) (median and IQR). 13 patients received intraoperative mannitol during PN and 11 did not. (Table 1) Covariates did not differ amongst the two groups. The average change in eGFR for the mannitol (+) and (-) groups were 0 (13) and 5.45 (6.23) respectively at first f/u. (p = 0.4616).  At second f/u, the average change in eGFR for the mannitol (+) and (-) groups was 10.75 (9.98) and 6.85 (11.81) respectively. (p = 0.3710) CKD upstaging also did not differ amongst the two groups at both first and second f/u visits. (p = 0.1243 and 0.7897 respectively) (Table 2)


Conclusions :

Our preliminary data suggests that intraoperative mannitol provides no added benefit to the majority of PN patients with baseline eGFR < 60 (CKD III-V disease).

Saikrishnaraya Doppalapudi

Medical Student
Rutgers - New Jersey Medical School

Presentation(s):

    Send Email for Saikrishnaraya Doppalapudi

    Jessica A. Connor

    Medical student
    Rutgers - New Jersey Medical School

    Presentation(s):

      Send Email for Jessica Connor

      Thaiphi Luu

      Medical Student
      Rutgers - New Jersey Medical School

      Thaiphi Luu, 4th year medical student, Rutgers New Jersey Medical School

      Presentation(s):

        Send Email for Thaiphi Luu

        Benjamin Press

        Medical Student
        Rutgers - New Jersey Medical School

        Presentation(s):

          Send Email for Benjamin Press

          Radhika Ragam

          Medical Student
          Rutgers - New Jersey Medical School

          Radhika Ragam, BS
          Medical Student - Rutgers New Jersey Medical School

          Presentation(s):

            Send Email for Radhika Ragam

            Helaine Koster

            Hackensack University Medical Center

            Presentation(s):

              Send Email for Helaine Koster

              Tenzin Lama-Tamang

              Hackensack University Medical Center

              Presentation(s):

                Send Email for Tenzin Lama-Tamang

                John Stites

                Fellow, Endourology, Laparoscopy, Robotic Surgery
                Hackensack University Medical Center

                Presentation(s):

                  Send Email for John Stites

                  Mutahar Ahmed

                  Attending Urologist
                  Hackensack University Medical Center

                  Mutahar Ahmed MD FACS
                  Director of the Center for Bladder Cancer and Reconstructive Urologic Surgery at Hackensack University Medical Center, in Hackensack, NJ
                  Clinical Assitant Professor Hackensack Meridian Seton Hall School of Medicine
                  Clinical Assistant Professor Rutgers University School of Medicine

                  Presentation(s):

                    Send Email for Mutahar Ahmed

                    Gregory Lovallo

                    Attending Urologist
                    Hackensack University Medical Center

                    Presentation(s):

                      Send Email for Gregory Lovallo

                      Ravi Munver

                      Professor & Vice Chair
                      Hackensack University Medical Center

                      Dr. Munver received his undergraduate education at Cornell University. He received his medical education at Cornell University Medical College and completed residency training in urologic surgery at Duke University Medical Center. He received fellowship training in robotic, laparoscopic, and endoscopic surgery at New York-Presbyterian Hospital/Weill Cornell Medical Center.

                      Dr. Munver is Vice Chair and Chief of Minimally Invasive and Robotic Urologic Surgery in the Department of Urology at Hackensack University Medical Center. He is a Professor of Urology at Hackensack Meridian School of Medicine at Seton Hall University and at Rutgers New Jersey Medical School. He is the founding Director of the Hackensack University Medical Center Endourology, Laparoscopy, and Robotic Surgery Fellowship Program.

                      Dr. Munver is a passionate academician and educator, and has lectured in 21 countries spanning 5 continents. He has authored more than 400 scientific manuscripts, articles, book chapters, and abstracts.

                      Presentation(s):

                        Send Email for Ravi Munver

                        Michael D. Stifelman

                        Chairman - Department of Urology
                        Hackensack University Medical Center

                        Presentation(s):

                          Send Email for Michael Stifelman


                          Assets

                          MP18-6 - Intraoperative mannitol during partial nephrectomy does not benefit patients with diminished renal functional reserve at baseline



                          Attendees who have favorited this

                          Please enter your access key

                          The asset you are trying to access is locked. Please enter your access key to unlock.

                          Send Email for MP18-6 - Intraoperative mannitol during partial nephrectomy does not benefit patients with diminished renal functional reserve at baseline