[Partial nephrectomy by selective renal parenchymal clamping using a new clamp]. / Néphrectomie partielle par clampage parenchymateux sélectif utilisant un nouveau clamp.

OBJECTIVE: To study the results of open partial nephrectomy by selective renal parenchymal clamping using a new renal parenchyma clamp, the Réniclamp. MATERIAL AND METHODS: Partial nephrectomy was performed in 37 patients using the Réniclamp for an imperative indication in 7 patients (solitary kidneys) and an elective indication in 30 patients. The tumour was situated in a pole in 22 cases and on the lateral border of the kidney in 15 cases. The mean tumour diameter was 29 mm (range: 10 - 60 mm). RESULTS: The mean operating time was 147 minutes and the mean clamping time was 25 minutes. Mean blood loss was 191 cc (range : 50-450 cc) and no patient required blood transfusion. No cases of slipping of the clamp or renal parenchymal lesion due to the clamp were observed. COMPLICATIONS: A urinary fistula treated by endoscopy and obstructive clot of the upper urinary tract, which required endoscopic treatment and selective embolisation. The surgical margins were negative in every case. CONCLUSION: Partial nephrectomy by selective renal parenchymal clamping is an alternative to the pedicle clamping technique in almost every case of renal tumour except for central renal lesions. Réniclamp distributes the pressure homogeneously, avoiding damage to the parenchyma due to excess pressure on the proximal part of the clamp and bleeding due to insufficient pressure on the distal part of the clamp.