Nine-yr experience of 700 hand-assisted laparoscopic donor nephrectomies in Japan.
Clin Transplant
; 26(5): 797-807, 2012.
Article
em En
| MEDLINE
| ID: mdl-22449123
ABSTRACT
OBJECTIVE:
We reviewed the introduction of a new, minimally invasive, live kidney donation program in our department.METHODS:
The operating times of 700 consecutive hand-assisted laparoscopic donor nephrectomies (HALDN) conducted from February 2001 to April 2010 were examined. The risk factors for prolonging operating times were analyzed and major surgical barriers in HALDN investigated.RESULTS:
All procedures were successfully performed without the requirement for conversion to open surgery or blood transfusion. The overall prevalence of perioperative complications was 3.0%, with no mortality, in this non-obese donor population with mean body mass index (BMI) as low as 23.2 ± 3.2 kg/m(2) . After the initial learning curve, a second learning plateau was detected until around case 300. Multivariate analyses showed that the significant risk factors were male sex, graft weight, number of renal arteries, right nephrectomy, and previous epigastric surgery (p < 0.05). HALDN provided direct handling of the surgical field, secure vascular control, safe manipulation of adhesive tissues, and served to maintain surgical safety. Mean values of the BMI of donors had a significant positive correlation with the prevalence of complications between large studies (p = 0.042).CONCLUSIONS:
Laparoscopic donor nephrectomy was safely introduced and established in a single institution with the help of the hand-assistance method.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
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Transplante de Rim
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Laparoscopia
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Doadores Vivos
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Nefrectomia
Tipo de estudo:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
Asia
Idioma:
En
Revista:
Clin Transplant
Assunto da revista:
TRANSPLANTE
Ano de publicação:
2012
Tipo de documento:
Article
País de afiliação:
Japão