Laparoscopic versus open live donor nephrectomy: outcomes analysis of 266 consecutive patients.
Surg Endosc
; 23(7): 1564-8, 2009 Jul.
Article
en En
| MEDLINE
| ID: mdl-19263157
ABSTRACT
BACKGROUND:
Minimally invasive surgical techniques have become the preferred method for live donor nephrectomy (DN) in many centers. We compared our experience with laparoscopic and open DN in a single institution.METHODS:
Data for 266 consecutive live DNs were collected. Demographic, intraoperative, and postoperative data were compared.RESULTS:
A total of 199 hand-assisted laparoscopic (HAL) DNs, 18 totally laparoscopic (TL), and 49 open DNs were performed. Laparoscopic DN was associated with a shorter operative time (p < 0.013), less blood loss (p < 0.0001), and shorter hospital stay (p < 0.0001) than open DN. Warm ischemia time was less for HAL versus TL DN (59.9 vs. 90.0 seconds; p < 0.0001). Compared with open DN, laparoscopic patients had fewer complications (p < 0.03), fewer wound infections (p < 0.004), less wound paresthesias (p < 0.0009), and fewer complaints of chronic incisional pain (p < 0.0001). Delayed graft function during the first 24 h postoperatively was significantly less for the laparoscopic DN versus the open cases (12.9% vs. 30.4%; p = 0.003), but the need for hemodialysis for the recipient was similar between groups (6.9% vs. 5%; p = not significant).CONCLUSIONS:
Laparoscopic DN resulted in less blood loss, reduced operative time, and shorter hospital stay than open DN. Hand-assisted laparoscopic DN has the potential to decrease warm ischemia time for renal allografts. Donors managed laparoscopically had fewer complications, significantly less wound-related morbidity, and less delayed graft function than patients who underwent open DN.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Laparoscopía
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Donadores Vivos
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Recolección de Tejidos y Órganos
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Nefrectomía
Tipo de estudio:
Evaluation_studies
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Observational_studies
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Risk_factors_studies
Límite:
Adolescent
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Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Surg Endosc
Asunto de la revista:
DIAGNOSTICO POR IMAGEM
/
GASTROENTEROLOGIA
Año:
2009
Tipo del documento:
Article
País de afiliación:
Estados Unidos