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Iliac Fossa Muscle Splitting Incision in Laparoscopic Donor Nephrectomy: A comparison With the Suprapubic Approach.
Silva, Arnaldo N S; Georgiades, Fanourios; Bath, Michael F; Hosgood, Sarah A; Nicholson, Michael L.
Afiliación
  • Silva ANS; Division of Surgery, Department of Surgery, Cambridge University Hospitals, Addenbrooke's, Cambridge, United Kingdom. Electronic address: a.n.s.silva@doctors.org.uk.
  • Georgiades F; Division of Surgery, Department of Surgery, Cambridge University Hospitals, Addenbrooke's, Cambridge, United Kingdom.
  • Bath MF; Division of Surgery, Department of Surgery, Cambridge University Hospitals, Addenbrooke's, Cambridge, United Kingdom.
  • Hosgood SA; Division of Surgery, Department of Surgery, Cambridge University Hospitals, Addenbrooke's, Cambridge, United Kingdom.
  • Nicholson ML; Division of Surgery, Department of Surgery, Cambridge University Hospitals, Addenbrooke's, Cambridge, United Kingdom.
Urology ; 143: 142-146, 2020 09.
Article en En | MEDLINE | ID: mdl-32562777
ABSTRACT

OBJECTIVE:

To compare the outcomes of a transverse suprapubic incision with peritoneal access through the midline (SPM) and an iliac fossa muscle splitting (IFMS) incision for kidney retrieval during laparoscopic donor nephrectomy (LDN). MATERIAL AND

METHODS:

This observational retrospective comparative cohort study was performed using data from a prospectively maintained database to compare the outcomes of 2 different incisions (SPM n = 35 and IFMS n = 35) used for kidney retrieval during LDN. All incisions were infiltrated with local anesthesia at the time of closure. The primary outcome measure was postoperative analgesic requirements. Secondary outcome measures included donor complication rates and recipient outcomes. Selection bias was minimized by the study of 2 consecutive series of donors.

RESULTS:

Overall, 28 of the 70 (40%) of the total cohort were male. There was no difference between age (IFMS 49 ± 12 vs SPM 49 ± 11 years, P = .317), body mass index (IFMS 26.5 ± 3.9 vs SPM 25.9 ± 3.3 kg/m2, P = .493), and total postoperative opioid analgesic requirements (IFMS 213 ± 168 vs SPM 211 ± 168 mg, P = .807) between the 2 groups. The volume of local anesthetic infiltrated during wound closure was higher in the IFMS 0.470 ± 0.160 vs SPM 0.370 ± 0.234 mL/kg (P = .030) and associated with a reduction in postoperative opioid requirements (r = -0.511, P = .002). There were no major donor or recipient postoperative complications in either group and no difference in renal allograft function at 3-, 6-, 9-, or 12 months post-transplant.

CONCLUSION:

An iliac fossa muscle splitting incision is a straightforward and safe approach, providing a reasonable alternative to the more traditional and widely used suprapubic incision for kidney retrieval during LDN.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Dolor Postoperatorio / Trasplante de Riñón / Laparoscopía / Recolección de Tejidos y Órganos / Nefrectomía Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Urology Año: 2020 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Dolor Postoperatorio / Trasplante de Riñón / Laparoscopía / Recolección de Tejidos y Órganos / Nefrectomía Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Urology Año: 2020 Tipo del documento: Article