Effect of Ketorolac and Remote Ischemic Preconditioning on Renal Ischemia-reperfusion Injury in Patients Undergoing Partial Nephrectomy

Partial nephrectomy is a widely accepted alternative to radical nephrectomy in patients with clinically localized, unilateral renal cell carcinoma and a normal contralateral kidney. Interruption of renal blood flow via pedicle clamping is often necessary during partial nephrectomy, especially for complex tumors with deep parenchymal invasion. Ischemia-reperfusion injury is a complex process involving several mechanisms including renal vasoconstriction, extensive tubular damage and glomerular injury. The investigators will examine the postoperative renal function of patients who received intraoperative ketorolac and remote ischemic preconditioning during partial nephrectomy.

Inclusion Criteria:

• ASA l and ll
• age 20-65
• patients undergoing partial nephrectomy

Exclusion Criteria:

• preoperative liver or renal dysfunction,
• coagulopathy,
• chronic alcoholism,
• hypersensitivity of NSAID,
• history of warfarin,
• history of gastric ulcer