RESUMEN
The objective of this study was to compare two surgical approaches for living donor nephrectomy: transperitoneal anterior approach and the hand-assisted laparoscopic nephrectomy. Between January 2001 and October 2003 we performed 63 kidney transplantations from living donors. The transperitoneal anterior approach was used in 36 cases and the hand-assisted laparoscopic nephrectomy in 27. Outcomes were compared in terms of hospital stay, postoperative analgesia, and graft quality. Mean hospital stay was 4.7 days in the transperitoneal anterior approach group and 3.7 days in the hand-assisted laparoscopic group (P < .005). Postoperative analgesia dosage was significantly lower in the hand-assisted laparoscopic group (P < .001). Surgical complications and graft quality were similar. We concluded that hand-assisted laparoscopic nephrectomy patients had shorter hospital stays and less pain in the postoperative period, with better cosmetic results and equivalent graft quality compared to transperitoneal anterior approach patients.
Asunto(s)
Trasplante de Riñón/métodos , Laparoscopía/métodos , Donadores Vivos , Nefrectomía/métodos , Recolección de Tejidos y Órganos/métodos , Adulto , Diuresis , Femenino , Prueba de Histocompatibilidad , Humanos , Trasplante de Riñón/fisiología , Masculino , Persona de Mediana EdadRESUMEN
We report a living donor who underwent laparoscopic nephrectomy using a hand-assisted device (HALD). At preoperative arteriography the donor showed a renal artery aneurysm. The patient was a 37-year-old female, 166 cm height, white, weighing 87 kg, HLA identical to the recipient. HALD was indicated due to the better visualization of renal pedicle and greater security in an obese patient. Renal artery aneurysm is a rare condition, with many possible complications. The method proved to be adequate and safe for donor nephrectomy, despite a renal artery aneurysm.