Long-term functional evaluation of the treated kidney in a prospective series of patients who underwent laparoscopic partial nephrectomy for small renal tumors.

Background: Renal scintigraphy may allow long-term monitoring of ischemic damage after partial nephrectomy (PN). Objective: Evaluate use of renal scintigraphy for evaluating long-term effects of warm ischemia on renal function in patients with a normal contralateral kidney. Design, setting, and participants: We prospectively examined kidney function of 54 patients who underwent laparoscopic PN (LPN). Minimum follow-up time was 4 yr. Intervention: LPN was performed with warm ischemia by transperitoneal or retroperitoneal approach. Measurements: Demographic, perioperative, and pathologic data and postoperative complications were registered. Split renal function (SRF) and effective renal plasma flow (ERPF) were evaluated by renal scintigraphy preoperatively, at 3 and 12 mo postoperatively, then yearly. Baseline weighted differentials (b-WDs) of both SRF and ERPF in the affected kidney were calculated between baseline condition and every time point. Multivariate linear regression was used to find independent variables for increased b-WDs at 3 and 48 mo. P values<0.05 were considered significant. Results and limitations: The SRF and ERPF of kidneys treated by LPN decreased significantly at month 3 and subsequently remained stable through the duration of follow-up. Conversely, neither serum creatinine nor estimated glomerular filtration rate changed significantly during follow-up. The regression model showed statistical significance at month 3 for warm ischemia time (WIT) and age, whereas at 48 mo, statistical significance was reached by WIT alone. No new onset of cardiovascular disease was registered. No evidence of local recurrence was recorded with computed tomography scan. Our study may be underpowered due to small sample size; however, this is one of the largest long-term prospective series using renal scintigraphy to evaluate the renal function after LPN. Conclusions: WIT contributes to irreversible kidney damage observed at month 3 that does not appear to worsen

Use of 111In-DTPA-ocreotide scintigraphy in the diagnosis of neuroendocrine and non-neuroendocrine tumors of the lung. Preliminary results

BACKGROUND: The authors report their preliminary experience and results of the use of 111In-DTPA-octreotide scintigraphy (octreoscan) in the staging of neuroendocrine and non-neuroendocrine tumors of the lung. MATERIALS AND METHODS: From July 1995 to May 1996 twenty-six scintigraphic studies were performed in patients affected by lung cancer at the Department of Thoracic Surgery and at the Service of Nuclear Medicine of the University of Turin. RESULTS: Scintigraphy made it possible to detect the lesion in all the patients affected by neuroendocrine tumors and in 63.2% of the patients affected by non-neuroendocrine neoplasm of the lung. Scintigraphy also revealed mediastinal lymphnodal metastases in patients in which thoracic CT scan was negative: this result was confirmed by postoperative TNM. CONCLUSIONS: The authors stress the importance of 111In-DTPA-octreotide scintigraphy in a correct procedure of staging of neuroendocrine and non-neuroendocrine tumors of the lung and in the follow-up of neoplastic patients

RISULTATI PRELIMINARI SULL'UTILIZZO DELLA SCINTIGRAFIA CON OCTREOTIDE RADIOMARCATO COME METODICA DI DIAGNOSI DELLE NEOPLASIE NEUROENDOCRINE E NON NEUROENDOCRINE DEL POLMONE [Preliminary results on the use of scintigraphy with radiolabelled octreotide as diagnostic method in neuroendocrine and nonendocrine neoplasms of the lung]

Personal experience on the use of 111In-DTPA-octreotide scintigraphy (Octreoscan) in the staging of neuroendocrine and non-neuroendocrine tumors of the lung is reported. From July 1995 to May 1996 26 scintigraphic studies were performed in patients affected by lung cancer at the Department of Thoracic Surgery and at the Service of Nuclear Medicine of the University of Turin. The scintigraphy allowed to detect the lesion in all the neuroendocrine tumors and in 63.2% of the non neuroendocrine ones. Their preliminary results are discussed and stress is laid on the importance of this scintigraphic procedure in the staging and the follow-up of neoplastic patients