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1.
PLoS One ; 18(7): e0287790, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37410744

RESUMEN

The structure of coral-reef fish assemblages is affected by natural and anthropogenic factors such as the architectural complexity, benthic composition and physical characteristics of the habitat, fishing pressure and land-based input. The coral-reef ecosystem of South Kona, Hawai'i hosts diverse reef habitats with a relatively high live coral cover, but a limited number of studies have focused on the ecosystem or the fish assemblages. Here, we surveyed fish assemblages at 119 sites in South Kona in 2020 and 2021 and investigated the associations between the fish assemblages and environmental variables obtained from published Geographic Information System (GIS) layers, including depth, latitude, reef rugosity, housing density and benthic cover. The fish assemblages in South Kona were dominated by a relatively small number of widely occurring species. Multivariate analyses indicated that fish assemblage structure strongly correlated with depth, reefscape-level rugosity and sand cover individually, while the final parsimonious model included latitude, depth, housing density within 3-km of shore, chlorophyll-a concentration and sand cover. Univariate analysis revealed negative associations between housing density and fish species richness and abundance. Effects of environmental factors specific to fish trophic groups were also found. Reefscape-level rugosity had strong positive influences on the distributions of all herbivores (browsers, grazers and scrapers), while housing density had strong negative influences only on the abundance of browsers. Positive associations were also found between live coral cover and the presence of scrapers, as well as the abundance of corallivorous fish. This study intensively surveyed shallow coral reefs along the coastline of South Kona and was the most complete spatial survey on the reef fish assemblages to date. As it utilized GIS layers to assess large-scale patterns in the fish assemblages, future studies including in-situ environmental data may further reveal local-scale patterns and insights into factors affecting the structure of fish assemblages in Hawai'i.


Asunto(s)
Antozoos , Ecosistema , Animales , Hawaii , Arena , Arrecifes de Coral , Peces
2.
Ecol Appl ; 33(5): e2889, 2023 07.
Artículo en Inglés | MEDLINE | ID: mdl-37212375

RESUMEN

Translocation, often a management solution reserved for at-risk species, is a highly time-sensitive intervention in the face of a rapidly changing climate. The definition of abiotic and biotic habitat requirements is essential to the selection of appropriate release sites in novel environments. However, field-based approaches to gathering this information are often too time intensive, especially in areas of complex topography where common, coarse-scale climate models lack essential details. We apply a fine-scale remote sensing-based approach to study the 'akikiki (Oreomystis bairdi) and 'akeke'e (Loxops caeruleirostris), Hawaiian honeycreepers endemic to Kaua'i that are experiencing large-scale population declines due to warming-induced spread of invasive disease. We use habitat suitability modeling based on fine-scale light detection and ranging (lidar)-derived habitat structure metrics to refine coarse climate ranges for these species in candidate translocation areas on Maui. We found that canopy density was consistently the most important variable in defining habitat suitability for the two Kaua'i species. Our models also corroborated known habitat preferences and behavioral information for these species that are essential for informing translocation. We estimated a nesting habitat that will persist under future climate conditions on east Maui of 23.43 km2 for 'akikiki, compared to the current Kaua'i range of 13.09 km2 . In contrast, the novel nesting range for 'akeke'e in east Maui was smaller than its current range on Kaua'i (26.29 vs. 38.48 km2 , respectively). We were also able to assess detailed novel competitive interactions at a fine scale using models of three endemic Maui species of conservation concern: 'akohekohe (Palmeria dolei), Maui 'alauahio (Paroreomyza montana), and kiwikiu (Pseudonestor xanthophrys). Weighted overlap areas between the species from both islands were moderate (<12 km2 ), and correlations between Maui and Kaua'i bird habitat were generally low, indicating limited potential for competition. Results indicate that translocation to east Maui could be a viable option for 'akikiki but would be more uncertain for 'akeke'e. Our novel multifaceted approach allows for the timely analysis of both climate and vegetation structure at informative scales for the effective selection of appropriate translocation sites for at-risk species.


Asunto(s)
Especies en Peligro de Extinción , Passeriformes , Animales , Hawaii/epidemiología , Islas , Ecosistema
3.
Proc Natl Acad Sci U S A ; 119(19): e2123331119, 2022 05 10.
Artículo en Inglés | MEDLINE | ID: mdl-35500122

RESUMEN

Corals are a major habitat-building life-form on tropical reefs that support a quarter of all species in the ocean and provide ecosystem services to millions of people. Marine heat waves continue to threaten and shape reef ecosystems by killing individual coral colonies and reducing their diversity. However, marine heat waves are spatially and temporally heterogeneous, and so too are the environmental and biological factors mediating coral resilience during and following thermal events. This combination results in highly variable outcomes at both the coral bleaching and mortality stages of every event. This, in turn, impedes the assessment of changing reef-scale patterns of thermal tolerance or places of resistance known as reef refugia. We developed a large-scale, high-resolution coral mortality monitoring capability based on airborne imaging spectroscopy and applied it to a major marine heat wave in the Hawaiian Islands. While water depth and thermal stress strongly mediated coral mortality, relative coral loss was also inversely correlated with preheat-wave coral cover, suggesting the existence of coral refugia. Subsequent mapping analyses indicated that potential reef refugia underwent up to 40% lower coral mortality compared with neighboring reefs, despite similar thermal stress. A combination of human and environmental factors, particularly coastal development and sedimentation levels, differentiated resilient reefs from other more vulnerable reefs. Our findings highlight the role that coral mortality mapping, rather than bleaching monitoring, can play for targeted conservation that protects more surviving corals in our changing climate.


Asunto(s)
Antozoos , Animales , Antozoos/fisiología , Conservación de los Recursos Naturales , Arrecifes de Coral , Ecosistema , Calor , Refugio de Fauna
4.
Ecol Appl ; 32(2): e2519, 2022 03.
Artículo en Inglés | MEDLINE | ID: mdl-34918400

RESUMEN

Native forests of Hawai'i Island are experiencing an ecological crisis in the form of Rapid 'Ohi'a Death (ROD), a recently characterized disease caused by two fungal pathogens in the genus Ceratocystis. Since approximately 2010, this disease has caused extensive mortality of Hawai'i's keystone endemic tree, known as 'ohi'a (Metrosideros polymorpha). Visible symptoms of ROD include rapid browning of canopy leaves, followed by death of the tree within weeks. This quick progression leading to tree mortality makes early detection critical to understanding where the disease will move at a timescale feasible for controlling the disease. We used repeat laser-guided imaging spectroscopy (LGIS) of forests on Hawai'i Island collected by the Global Airborne Observatory (GAO) in 2018 and 2019 to derive maps of foliar trait indices previously found to be important in distinguishing between ROD-infected and healthy 'ohi'a canopies. Data from these maps were used to develop a prognostic indicator of tree stress prior to the visible onset of browning. We identified canopies that were green in 2018, but became brown in 2019 (defined as "to become brown"; TBB), and a corresponding set of canopies that remained green. The data mapped in 2018 showed separability of foliar trait indices between TBB and green 'ohi'a, indicating early detection of canopy stress prior to the onset of ROD. Overall, a combination of linear and non-linear analyses revealed canopy water content (CWC), foliar tannins, leaf mass per area (LMA), phenols, cellulose, and non-structural carbohydrates (NSC) are primary drivers of the prognostic spectral capability which collectively result in strong consistent changes in leaf spectral reflectance in the near-infrared (700-1300 nm) and shortwave-infrared regions (1300-2500 nm). Results provide insight into the underlying foliar traits that are indicative of physiological responses of M. polymorpha trees infected with Ceratocycstis and suggest that imaging spectroscopy is an effective tool for identifying trees likely to succumb to ROD prior to the onset of visible symptoms.


Asunto(s)
Myrtaceae , Árboles , Bosques , Hojas de la Planta/fisiología , Tecnología de Sensores Remotos
5.
Nat Commun ; 12(1): 1526, 2021 03 09.
Artículo en Inglés | MEDLINE | ID: mdl-33750781

RESUMEN

The past 40 years in Southeast Asia have seen about 50% of lowland rainforests converted to oil palm and other plantations, and much of the remaining forest heavily logged. Little is known about how fragmentation influences recovery and whether climate change will hamper restoration. Here, we use repeat airborne LiDAR surveys spanning the hot and dry 2015-16 El Niño Southern Oscillation event to measure canopy height growth across 3,300 ha of regenerating tropical forests spanning a logging intensity gradient in Malaysian Borneo. We show that the drought led to increased leaf shedding and branch fall. Short forest, regenerating after heavy logging, continued to grow despite higher evaporative demand, except when it was located close to oil palm plantations. Edge effects from the plantations extended over 300 metres into the forests. Forest growth on hilltops and slopes was particularly impacted by the combination of fragmentation and drought, but even riparian forests located within 40 m of oil palm plantations lost canopy height during the drought. Our results suggest that small patches of logged forest within plantation landscapes will be slow to recover, particularly as ENSO events are becoming more frequent.


Asunto(s)
El Niño Oscilación del Sur/efectos adversos , Bosques , Árboles , Clima Tropical , Arecaceae , Asia Sudoriental , Borneo , Cambio Climático , Sequías , Ecología , Humanos , Malasia , Hojas de la Planta , Bosque Lluvioso
6.
Proc Natl Acad Sci U S A ; 117(52): 33711-33718, 2020 12 29.
Artículo en Inglés | MEDLINE | ID: mdl-33318215

RESUMEN

Coral is the life-form that underpins the habitat of most tropical reef ecosystems, thereby supporting biological diversity throughout the marine realm. Coral reefs are undergoing rapid change from ocean warming and nearshore human activities, compromising a myriad of services provided to societies including coastal protection, fishing, and cultural practices. In the face of these challenges, large-scale operational mapping of live coral cover within and across reef ecosystems could provide more opportunities to address reef protection, resilience, and restoration at broad management- and policy-relevant scales. We developed an airborne mapping approach combining laser-guided imaging spectroscopy and deep learning models to quantify, at a large archipelago scale, the geographic distribution of live corals to 16-m water depth throughout the main Hawaiian islands. Airborne estimates of live coral cover were highly correlated with field-based estimates of live coral cover (R2 = 0.94). Our maps were used to assess the relative condition of reefs based on live coral, and to identify potential coral refugia in the face of human-driven stressors, including marine heat waves. Geospatial modeling revealed that water depth, wave power, and nearshore development accounted for the majority (>60%) of live coral cover variation, but other human-driven factors were also important. Mapped interisland and intraisland variation in live coral location improves our understanding of reef geography and its human impacts, thereby guiding environmental management for reef resiliency.


Asunto(s)
Antozoos/fisiología , Conservación de los Recursos Naturales , Arrecifes de Coral , Animales , Islas , Modelos Biológicos , Reproducibilidad de los Resultados
7.
Ecol Appl ; 27(8): 2443-2457, 2017 12.
Artículo en Inglés | MEDLINE | ID: mdl-28871610

RESUMEN

Severe drought has the potential to cause selective mortality within a forest, thereby inducing shifts in forest species composition. The southern Sierra Nevada foothills and mountains of California have experienced extensive forest dieback due to drought stress and insect outbreak. We used high-fidelity imaging spectroscopy (HiFIS) and light detection and ranging (LiDAR) from the Carnegie Airborne Observatory (CAO) to estimate the effect of forest dieback on species composition in response to drought stress in Sequoia National Park. Our aims were (1) to quantify site-specific conditions that mediate tree mortality along an elevation gradient in the southern Sierra Nevada Mountains, (2) to assess where mortality events have a greater probability of occurring, and (3) to estimate which tree species have a greater likelihood of mortality along the elevation gradient. A series of statistical models were generated to classify species composition and identify tree mortality, and the influences of different environmental factors were spatially quantified and analyzed to assess where mortality events have a greater likelihood of occurring. A higher probability of mortality was observed in the lower portion of the elevation gradient, on southwest- and west-facing slopes, in areas with shallow soils, on shallower slopes, and at greater distances from water. All of these factors are related to site water balance throughout the landscape. Our results also suggest that mortality is species-specific along the elevation gradient, mainly affecting Pinus ponderosa and Pinus lambertiana at lower elevations. Selective mortality within the forest may drive long-term shifts in community composition along the elevation gradient.


Asunto(s)
Biodiversidad , Sequías , Bosques , Árboles/fisiología , Altitud , California , Longevidad , Pinus/fisiología , Especificidad de la Especie
8.
New Phytol ; 214(3): 973-988, 2017 May.
Artículo en Inglés | MEDLINE | ID: mdl-27349599

RESUMEN

Average responses of forest foliar traits to elevation are well understood, but far less is known about trait distributional responses to elevation at multiple ecological scales. This limits our understanding of the ecological scales at which trait variation occurs in response to environmental drivers and change. We analyzed and compared multiple canopy foliar trait distributions using field sampling and airborne imaging spectroscopy along an Andes-to-Amazon elevation gradient. Field-estimated traits were generated from three community-weighting methods, and remotely sensed estimates of traits were made at three scales defined by sampling grain size and ecological extent. Field and remote sensing approaches revealed increases in average leaf mass per unit area (LMA), water, nonstructural carbohydrates (NSCs) and polyphenols with increasing elevation. Foliar nutrients and photosynthetic pigments displayed little to no elevation trend. Sample weighting approaches had little impact on field-estimated trait responses to elevation. Plot representativeness of trait distributions at landscape scales decreased with increasing elevation. Remote sensing indicated elevation-dependent increases in trait variance and distributional skew. Multiscale invariance of LMA, leaf water and NSC mark these traits as candidates for tracking forest responses to changing climate. Trait-based ecological studies can be greatly enhanced with multiscale studies made possible by imaging spectroscopy.


Asunto(s)
Altitud , Bosques , Hojas de la Planta/fisiología , Clima Tropical , Geografía , Modelos Lineales , Carácter Cuantitativo Heredable , Análisis Espectral
9.
Proc Natl Acad Sci U S A ; 113(28): E4043-51, 2016 07 12.
Artículo en Inglés | MEDLINE | ID: mdl-27354534

RESUMEN

Leaf economics spectrum (LES) theory suggests a universal trade-off between resource acquisition and storage strategies in plants, expressed in relationships between foliar nitrogen (N) and phosphorus (P), leaf mass per area (LMA), and photosynthesis. However, how environmental conditions mediate LES trait interrelationships, particularly at large biospheric scales, remains unknown because of a lack of spatially explicit data, which ultimately limits our understanding of ecosystem processes, such as primary productivity and biogeochemical cycles. We used airborne imaging spectroscopy and geospatial modeling to generate, to our knowledge, the first biospheric maps of LES traits, here centered on 76 million ha of Andean and Amazonian forest, to assess climatic and geophysical determinants of LES traits and their interrelationships. Elevation and substrate were codominant drivers of leaf trait distributions. Multiple additional climatic and geophysical factors were secondary determinants of plant traits. Anticorrelations between N and LMA followed general LES theory, but topo-edaphic conditions strongly mediated and, at times, eliminated this classic relationship. We found no evidence for simple P-LMA or N-P trade-offs in forest canopies; rather, we mapped a continuum of N-P-LMA interactions that are sensitive to elevation and temperature. Our results reveal nested climatic and geophysical filtering of LES traits and their interrelationships, with important implications for predictions of forest productivity and acclimation to rapid climate change.


Asunto(s)
Clima , Bosques , Hojas de la Planta/crecimiento & desarrollo , Tecnología de Sensores Remotos , Altitud , Geografía , Perú , Hojas de la Planta/metabolismo
10.
Proc Natl Acad Sci U S A ; 113(2): E249-55, 2016 Jan 12.
Artículo en Inglés | MEDLINE | ID: mdl-26712020

RESUMEN

The 2012-2015 drought has left California with severely reduced snowpack, soil moisture, ground water, and reservoir stocks, but the impact of this estimated millennial-scale event on forest health is unknown. We used airborne laser-guided spectroscopy and satellite-based models to assess losses in canopy water content of California's forests between 2011 and 2015. Approximately 10.6 million ha of forest containing up to 888 million large trees experienced measurable loss in canopy water content during this drought period. Severe canopy water losses of greater than 30% occurred over 1 million ha, affecting up to 58 million large trees. Our measurements exclude forests affected by fire between 2011 and 2015. If drought conditions continue or reoccur, even with temporary reprieves such as El Niño, we predict substantial future forest change.


Asunto(s)
Desecación , Sequías , Bosques , Hojas de la Planta/fisiología , California , Cambio Climático , Geografía , Imagenología Tridimensional , Agua
11.
PLoS One ; 10(12): e0145192, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26660502

RESUMEN

Factors controlling savanna woody vegetation structure vary at multiple spatial and temporal scales, and as a consequence, unraveling their combined effects has proven to be a classic challenge in savanna ecology. We used airborne LiDAR (light detection and ranging) to map three-dimensional woody vegetation structure throughout four savanna watersheds, each contrasting in geologic substrate and climate, in Kruger National Park, South Africa. By comparison of the four watersheds, we found that geologic substrate had a stronger effect than climate in determining watershed-scale differences in vegetation structural properties, including cover, height and crown density. Generalized Linear Models were used to assess the spatial distribution of woody vegetation structural properties, including cover, height and crown density, in relation to mapped hydrologic, topographic and fire history traits. For each substrate and climate combination, models incorporating topography, hydrology and fire history explained up to 30% of the remaining variation in woody canopy structure, but inclusion of a spatial autocovariate term further improved model performance. Both crown density and the cover of shorter woody canopies were determined more by unknown factors likely to be changing on smaller spatial scales, such as soil texture, herbivore abundance or fire behavior, than by our mapped regional-scale changes in topography and hydrology. We also detected patterns in spatial covariance at distances up to 50-450 m, depending on watershed and structural metric. Our results suggest that large-scale environmental factors play a smaller role than is often attributed to them in determining woody vegetation structure in southern African savannas. This highlights the need for more spatially-explicit, wide-area analyses using high resolution remote sensing techniques.


Asunto(s)
Ecosistema , Pradera , Madera/metabolismo , Clima , Sudáfrica
12.
J Biol Chem ; 290(28): 17074-84, 2015 Jul 10.
Artículo en Inglés | MEDLINE | ID: mdl-25969535

RESUMEN

Tryptophan was substituted for residues in all four transmembrane domains of connexin32. Function was assayed using dual cell two-electrode voltage clamp after expression in Xenopus oocytes. Tryptophan substitution was poorly tolerated in all domains, with the greatest impact in TM1 and TM4. For instance, in TM1, 15 substitutions were made, six abolished coupling and five others significantly reduced function. Only TM2 and TM3 included a distinct helical face that lacked sensitivity to tryptophan substitution. Results were visualized on a comparative model of Cx32 hemichannel. In this model, a region midway through the membrane appears highly sensitive to tryptophan substitution and includes residues Arg-32, Ile-33, Met-34, and Val-35. In the modeled channel, pore-facing regions of TM1 and TM2 were highly sensitive to tryptophan substitution, whereas the lipid-facing regions of TM3 and TM4 were variably tolerant. Residues facing a putative intracellular water pocket (the IC pocket) were also highly sensitive to tryptophan substitution. Although future studies will be required to separate trafficking-defective mutants from those that alter channel function, a subset of interactions important for voltage gating was identified. Interactions important for voltage gating occurred mainly in the mid-region of the channel and focused on TM1. To determine whether results could be extrapolated to other connexins, TM1 of Cx43 was scanned revealing similar but not identical sensitivity to TM1 of Cx32.


Asunto(s)
Conexinas/química , Uniones Comunicantes/química , Secuencia de Aminoácidos , Sustitución de Aminoácidos , Animales , Conexina 43/química , Conexina 43/genética , Conexina 43/metabolismo , Conexinas/genética , Conexinas/metabolismo , Femenino , Uniones Comunicantes/metabolismo , Membrana Dobles de Lípidos/química , Membrana Dobles de Lípidos/metabolismo , Modelos Moleculares , Datos de Secuencia Molecular , Mutagénesis Sitio-Dirigida , Oocitos/metabolismo , Dominios y Motivos de Interacción de Proteínas , Subunidades de Proteína , Ratas , Proteínas Recombinantes/química , Proteínas Recombinantes/genética , Proteínas Recombinantes/metabolismo , Triptófano/química , Xenopus laevis , Proteína beta1 de Unión Comunicante
13.
Ecol Appl ; 24(7): 1638-50, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-29210228

RESUMEN

Fragmentation poses one of the greatest threats to tropical forests with short-term changes to the structure of forest canopies affecting microclimate, tree mortality, and growth. Yet the long-term effects of fragmentation are poorly understood because (1) most effects require many decades to materialize, but long-term studies are very rare, (2) the effects of edges on forest canopy structure as a function of fragment size are unknown, and (3) edge effects are often confounded by fragment shape. We quantified the long-term (centennial) effects of fragmentation on forest canopy structure using airborne light detection and ranging (LiDAR) of 1060 Hawaiian rain forest fragments ranging in size from 0.02 to 1000 ha, created more than 130 years ago by flowing lava. Along with distance from edge, we developed a metric, minimum span, to gain additional insight into edge effects on three measures of canopy structure: canopy height, height variation, and gap fraction. Fragment size was a strong determinant of the three structural variables. Larger fragments had greater average height, larger variation in height, and smaller gap fraction. Minimum span had a large effect on the depth and magnitude of edge effects for the three structural variables. Locations associated with high span values (those surrounded by more forest habitat) showed little effect of distance to fragment edge. In contrast, locations with low span values (those more exposed to edges) were severely limited in canopy height, showed lower height variation, and were associated with greater gap fraction values. The minimum span attribute allows for a more accurate characterization of edge as well as fragment-level effects, and when combined with high resolution imagery, can improve planning of protected areas for long-term ecological sustainability and biodiversity protection.


Asunto(s)
Bosques , Clima Tropical , Arizona , Biodiversidad , Cambio Climático , Simulación por Computador , Conservación de los Recursos Naturales , Monitoreo del Ambiente , Modelos Biológicos , Factores de Tiempo
14.
Urology ; 80(4): 838-43, 2012 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-22921704

RESUMEN

OBJECTIVE: To evaluate the potential benefit of performing off-clamp robot-assisted partial nephrectomy as it relates to renal functional outcomes, while assessing the safety profile of this unconventional surgical approach. METHODS: Twenty-nine patients who underwent off-clamp robot-assisted partial nephrectomy for suspected renal cell carcinoma at Washington University between March 2008 and September 2011 (group 1) were matched to 29 patients with identical nephrometry scores and comparable baseline renal function who underwent robot-assisted partial nephrectomy with hilar clamping during the same period (group 2). The matched cohorts' perioperative and renal functional outcomes were compared at a mean 9-month follow-up. RESULTS: Mean estimated blood loss was 146.4 mL in group 1, versus 103.9 mL in group 2 (P = .039). Mean hilar clamp time was 0 minutes in group 1 and 14.7 minutes in group 2. No perioperative complications were encountered in group 1; 1 Clavien-2 complication (3.4%) occurred in group 2 (P = 1.000). At 9-month follow-up, mean estimated glomerular filtration rate in group 1 was 79.9 versus 84.8 mL/min/1.73 m(2) preoperatively (P = .013); mean estimated glomerular filtration rate in group 2 was 74.1 versus 85.8 mL/min/1.73 m(2) preoperatively (P < .001). Hence, estimated glomerular filtration rate declined by a mean of 4.9 mL/min/1.73 m(2) in group 1 versus 11.7 mL/min/1.73 m(2) in group 2 (P = .033). CONCLUSION: Off-clamp robot-assisted partial nephrectomy is associated with a favorable morbidity profile and relatively greater renal functional preservation compared to clamped robot-assisted partial nephrectomy. Nevertheless, the benefit is small in renal functional terms and may have very limited clinical relevance.


Asunto(s)
Carcinoma de Células Renales/fisiopatología , Carcinoma de Células Renales/cirugía , Neoplasias Renales/fisiopatología , Neoplasias Renales/cirugía , Nefrectomía/métodos , Anciano , Pérdida de Sangre Quirúrgica , Transfusión Sanguínea , Estudios de Casos y Controles , Constricción , Estudios de Seguimiento , Tasa de Filtración Glomerular , Humanos , Persona de Mediana Edad , Neoplasia Residual , Nefrectomía/efectos adversos , Estudios Retrospectivos , Robótica , Factores de Tiempo
15.
J Endourol ; 26(10): 1284-9, 2012 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-22524453

RESUMEN

BACKGROUND AND PURPOSE: Because of the impact warm ischemia time may have on renal function, various surgical techniques have been proposed to minimize or eliminate warm ischemia. The purpose of this study is to evaluate our initial renal functional outcomes of off-clamp robot-assisted partial nephrectomy (RAPN), while assessing the safety profile of this unconventional surgical approach. PATIENTS AND METHODS: We performed a retrospective review of our off-clamp RAPN experience between August 2007 and January 2012. All patients with baseline and postoperative serum creatinine determinations were included. Patient demographics, operative information, perioperative outcomes, and renal functional outcomes were evaluated for this cohort. RESULTS: Forty-two patients with a mean age of 59.9 years (standard deviation [SD]=12) had a median follow-up of 100 days (range 1-1007 days). In all cases, warm ischemia time was 0 minutes. Mean operative time was 143 minutes (SD=59), and median estimated blood loss was 138 mL (range 50-1500 mL). No intraoperative complications were encountered, and all surgical margins were negative. Our postoperative complication rate was 14.3%. At the most recent follow-up, the mean estimated glomerular filtration rate (eGFR) was 76.2 mL/min/1.73 m(2) (SD=27.6), compared with 78.5 mL/min/1.73 m(2) (SD=28.9) preoperatively (P=0.11). Therefore, the mean eGFR decline of 2.3 mL/min/1.73 m(2) (SD=9.1) was not significant. CONCLUSIONS: Off-clamp RAPN is associated with minimal morbidity and minimal decline in renal function on short-term follow-up. Further studies and continued monitoring of renal function are needed to determine if off-clamp RAPN provides any advantage in renal function preservation relative to the traditional RAPN with vascular clamping.


Asunto(s)
Carcinoma de Células Renales/cirugía , Hospitales Universitarios , Neoplasias Renales/cirugía , Nefrectomía/métodos , Robótica/métodos , Carcinoma de Células Renales/diagnóstico , Constricción , Femenino , Estudios de Seguimiento , Tasa de Filtración Glomerular , Humanos , Riñón/fisiopatología , Riñón/cirugía , Neoplasias Renales/diagnóstico , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Tempo Operativo , Periodo Posoperatorio , Estudios Retrospectivos , Resultado del Tratamiento , Washingtón
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