Neoplasms

All Conditions

Urinary Tract, Sexual Organs, and Pregnancy Conditions

Rare Diseases

Carcinoma

Carcinoma, Renal Cell

Adenocarcinoma

Neoplasms, Glandular and Epithelial

Neoplasms by Histologic Type

Kidney Neoplasms

Urologic Neoplasms

Urogenital Neoplasms

Urogenital Diseases

Female Urogenital Diseases

Pregnancy Complications

Female Urogenital Diseases and Pregnancy Complications

Kidney Diseases

Urologic Diseases

Male Urogenital Diseases

Renal Cell Carcinoma

Clear Cell Renal Cell Carcinoma

The renal artery is occluded to 30% of it's baseline, prior to kidney tumour removal

Hypoperfusion of renal artery

Michael Jewett, M.D.

Many patients who are candidates for nephron-sparing surgery, partial nephrectomy is now the standard treatment with a surgical, small, clinical T1 tumor (\<7 cm). In many recent studies, partial nephrectomy provides equivalent oncologic, and superior functional, outcomes compared with the standard radical nephrectomy over the short and long term (2, 3). Partial nephrectomy techniques, whether open, laparoscopic or robotic, typically involve hilar clamping, which creates the desired bloodless operative field, allowing for more precise tumor excision and renal reconstruction. This hilar clamping eventually may lead to ischemic kidney injury which can compromise the functional outcomes of the remaining kidney.We are working now to develop a novel technique of Hypo-Perfusion by achieving partial renal arterial clamping, with the goal of completely eliminating surgical ischemia to the renal remnant.

Novel Controlled Hypo-Perfusion Technique in Partial Nephrectomy

A Pilot Study to Examine a Novel Controlled Hypo-Perfusion Technique in Partial Nephrectomy

renal function will be measured using creatinine, eGFR, 24 hr creat clearance, and NGAL biomarker of acute kidney injury

University Health Network, Toronto

Nervous System Diseases

Nutritional and Metabolic Diseases

Symptoms and General Pathology

Brain Neoplasms

Hyperlactatemia

Central Nervous System Neoplasms

Nervous System Neoplasms

Brain Diseases

Central Nervous System Diseases

Metabolic Diseases

Central Nervous System Depressants

All Drugs and Chemicals

Anesthetics

Fatma Özkan Sipahioglu

The investigators aimed to research the incidence of hyperlactatemia in craniotomy cases, the relationship of lactate elevation with tumor type and other factors that may be related, and whether the general anesthesia method applied (inhalation anesthesia or total ıntravenous anesthesia) affects lactate level.

Lactate level is one of the easy-to-measure parameters that are frequently used in anesthesia and intensive care clinical practice, especially to evaluate the severity of disease and the response to treatment. In patients with high lactate levels, the first considerations are hypoperfusion and sepsis. However, many causes such as trauma, seizures, ischemia, diabetic ketoacidosis, thiamine deficiency, malignancies, liver dysfunction, genetic disorders, toxins, drugs, etc. can be associated with increased lactate. Many tissues in the body can produce lactate. 25% of production is from muscle, 25% skin, 20% brain, 20% RBC and 10% bowel cells. Some malignancies, especially hematological cancers, have also been associated with increased lactate. In recent years, it has been reported that serum lactate levels are associated with the degree of glial tumor malignancy, and that lactate can even be used as a non-invasive malignancy biomarker in brain tumors. In a recent study, it was reported that the type of 'glioblastoma multiforme' among patients who underwent craniotomy with the diagnosis of intracranial brain tumor was an independent influencer factor for preoperative and postoperative hyperlactatemia. Anesthesia is one of the factors that can affect lactate levels due to its effect on systemic perfusion and the hepatic effects of anesthetic drugs. It looks like that there is no study in the literature on the effect of anesthesia technique on hyperlactatemia in patients who underwent craniotomy. Therefore the investigators aimed to research the incidence of hyperlactatemia in craniotomy cases, the relationship of lactate elevation with tumor type and other factors that may be related, and whether the general anesthesia method applied (inhalation anesthesia or total ıntravenous anesthesia) affects lactate level.

The Relationship of Anesthesia Method With Serum Lactate Level in Craniotomies

basal lactate level via arterial blood gas at the beginning of surgery

lactate level via arterial blood gas at one hour after the beginning of surgery

lactate level via arterial blood gas at three hour after the beginning of surgery

lactate level via arterial blood gas at the end of the surgery

Ankara Diskapi Training and Research Hospital

Principal Investigator, Anesthesiologist

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Novel Controlled Hypo-Perfusion Technique in Partial Nephrectomy	NCT01720693	Partial Nephrec... Renal Cell Carc...	Hypoperfusion o...	18 Years - 90 Years	University Health Network, Toronto
The Relationship of Anesthesia Method With Serum Lactate Level in Craniotomies	NCT05145049	Intracranial Ne... Hyperlactatemia Brain Tumor Hypoperfusion		18 Years -	Ankara Diskapi Training and Research Hospital
The Relationship of Anesthesia Method With Serum Lactate Level in Craniotomies	NCT05145049	Intracranial Ne... Hyperlactatemia Brain Tumor Hypoperfusion		18 Years -	Ankara Diskapi Training and Research Hospital

Spots Global Cancer Trial Database for hypoperfusion