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A comparison of hand-assisted and pure laparoscopic techniques in live donor nephrectomy.

Branco AW, Kondo W, Branco Filho AJ, George MA, Rangel M, Stunitz LC - Clinics (Sao Paulo) (2008)

Bottom Line: The operative data and post-operative courses were reviewed.Information was collected on the operative time, warm ischemia time, estimated blood loss, intra-operative complications, time to first oral intake, length of hospital stay, and post-operative complications.The data were analyzed using Student's t -tests and Fisher exact tests as appropriate, with statistical significance defined as p < 0.05.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Red Cross Hospital, Curitiba, PA, Brazil.

ABSTRACT

Purpose: To compare hand-assisted laparoscopic donor nephrectomy and pure laparoscopic live donor nephrectomy techniques in live donor nephrectomy.

Methods: In this retrospective study, we included all patients submitted to hand-assisted laparoscopic donor nephrectomy and pure laparoscopic live donor nephrectomy between May 2002 and December 2007. The operative data and post-operative courses were reviewed. Information was collected on the operative time, warm ischemia time, estimated blood loss, intra-operative complications, time to first oral intake, length of hospital stay, and post-operative complications. The data were analyzed using Student's t -tests and Fisher exact tests as appropriate, with statistical significance defined as p < 0.05.

Results: The means of the operative duration, warm ischemia time and intra-operative bleeding were 83 min, 3.6 min and 130.9 cc, respectively, for hand-assisted laparoscopic donor nephrectomy, and 78.4 min, 2.5 min and 98.9 cc, respectively, for pure laparoscopic live donor nephrectomy (p=0.29, p<0.0001 and p=0.08, respectively). Intra-operative complications occurred in 6% of patients submitted to hand-assisted laparoscopic donor nephrectomy and in 4.5% of those submitted to pure laparoscopic live donor nephrectomy (p=0.68). Only one patient from each group required conversion to open surgery; one person receiving hand-assisted laparoscopic donor nephrectomy had bleeding and one person receiving pure laparoscopic live donor nephrectomy had low carbon dioxide levels during the warm ischemia period. Compared with patients receiving hand-assisted laparoscopic donor nephrectomy, patients submitted to pure laparoscopic live donor nephrectomy were able to take their first meal earlier (12.5 vs. 9.2 hours, p=0.046), were discharged home sooner (2.8 vs. 1.4 days, p<0.0001) and had fewer post-operative complications (7.5% vs. 0.6%, p=0.04).

Conclusions: Pure laparoscopic live donor nephrectomy had some advantages over hand-assisted laparoscopic donor nephrectomy in terms of the warm ischemia time, time to first oral intake, length of hospital stay, and post-operative donor complications.

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Related in: MedlinePlus

The double right renal artery (arrow) was dissected up to its origin in the right lateral edge of the aorta - the vena cava and the renal artery were isolated using a tape
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Related In: Results  -  Collection


getmorefigures.php?uid=PMC2664281&req=5

f5-15-cs-0186: The double right renal artery (arrow) was dissected up to its origin in the right lateral edge of the aorta - the vena cava and the renal artery were isolated using a tape

Mentions: When necessary, maximization of the length of the right renal vein9 (Figures 3 and 4) or artery8 (Figure 5) was performed.


A comparison of hand-assisted and pure laparoscopic techniques in live donor nephrectomy.

Branco AW, Kondo W, Branco Filho AJ, George MA, Rangel M, Stunitz LC - Clinics (Sao Paulo) (2008)

The double right renal artery (arrow) was dissected up to its origin in the right lateral edge of the aorta - the vena cava and the renal artery were isolated using a tape
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2664281&req=5

f5-15-cs-0186: The double right renal artery (arrow) was dissected up to its origin in the right lateral edge of the aorta - the vena cava and the renal artery were isolated using a tape
Mentions: When necessary, maximization of the length of the right renal vein9 (Figures 3 and 4) or artery8 (Figure 5) was performed.

Bottom Line: The operative data and post-operative courses were reviewed.Information was collected on the operative time, warm ischemia time, estimated blood loss, intra-operative complications, time to first oral intake, length of hospital stay, and post-operative complications.The data were analyzed using Student's t -tests and Fisher exact tests as appropriate, with statistical significance defined as p < 0.05.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Red Cross Hospital, Curitiba, PA, Brazil.

ABSTRACT

Purpose: To compare hand-assisted laparoscopic donor nephrectomy and pure laparoscopic live donor nephrectomy techniques in live donor nephrectomy.

Methods: In this retrospective study, we included all patients submitted to hand-assisted laparoscopic donor nephrectomy and pure laparoscopic live donor nephrectomy between May 2002 and December 2007. The operative data and post-operative courses were reviewed. Information was collected on the operative time, warm ischemia time, estimated blood loss, intra-operative complications, time to first oral intake, length of hospital stay, and post-operative complications. The data were analyzed using Student's t -tests and Fisher exact tests as appropriate, with statistical significance defined as p < 0.05.

Results: The means of the operative duration, warm ischemia time and intra-operative bleeding were 83 min, 3.6 min and 130.9 cc, respectively, for hand-assisted laparoscopic donor nephrectomy, and 78.4 min, 2.5 min and 98.9 cc, respectively, for pure laparoscopic live donor nephrectomy (p=0.29, p<0.0001 and p=0.08, respectively). Intra-operative complications occurred in 6% of patients submitted to hand-assisted laparoscopic donor nephrectomy and in 4.5% of those submitted to pure laparoscopic live donor nephrectomy (p=0.68). Only one patient from each group required conversion to open surgery; one person receiving hand-assisted laparoscopic donor nephrectomy had bleeding and one person receiving pure laparoscopic live donor nephrectomy had low carbon dioxide levels during the warm ischemia period. Compared with patients receiving hand-assisted laparoscopic donor nephrectomy, patients submitted to pure laparoscopic live donor nephrectomy were able to take their first meal earlier (12.5 vs. 9.2 hours, p=0.046), were discharged home sooner (2.8 vs. 1.4 days, p<0.0001) and had fewer post-operative complications (7.5% vs. 0.6%, p=0.04).

Conclusions: Pure laparoscopic live donor nephrectomy had some advantages over hand-assisted laparoscopic donor nephrectomy in terms of the warm ischemia time, time to first oral intake, length of hospital stay, and post-operative donor complications.

Show MeSH
Related in: MedlinePlus