Laparoscopic Bilateral Synchronous Nephrectomy for Autosomal Dominant Polycystic Kidney Disease: The Initial Experience

Gill, Inderbir S.; Kaouk, Jihad; Hobart, Michael G.; Sung, Gyung Tak; Schweizer, Dana; Braun, William E.

doi:10.1016/s0022-5347(05)66435-x

Cited by 80 publications

(65 citation statements)

References 15 publications

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“…Future possibilities can be a laparoscopic approach at the same operation. 7 The operative time increased a mean of 70 minutes, the need for fluids and blood products was greater, but the hemodynamic parameters were comparable at the moment of reperfusion, allowing similar short-and long-term outcomes for grafts and patients. There was only one surgical (urologic) complication in the nephrectomy group, allowing us to conclude that this is a safe procedure.…”

Section: Discussionmentioning

confidence: 97%

Simultaneous Renal Transplantation and Native Nephrectomy in Patients With Autosomal-Dominant Polycystic Kidney Disease

Nunes¹,

Mota²,

Alves³

et al. 2007

Transplantation Proceedings

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Our objective was to study the influence on transplant outcome of unilateral native nephrectomy of massively enlarged kidneys at the time of renal transplantation among patients with end-stage renal disease owing to autosomal-dominant polycystic kidney disease (ADPKD). Patients and Methods. We studied 159 renal transplants in patients with ADPKD divided into two groups according to the need to perform a unilateral native nephrectomy owing to enlarged kidneys (Nϩ; n ϭ 143) versus those not (N0; n ϭ 16) needing this procedure. Parameters related to the donors, grafts, recipients, and operative data were correlated with short-and long-term outcomes. The groups were homogeneous in terms of recipient and donor ages, genders, HLA compatibilities, and length of pretransplant dialysis. Results. When no nephrectomy was needed surgery length was shorter (N0, 3.01 vs. Nϩ, 4.23 hours; P Ͻ .001), less intraoperative crystalloids were infused (N0, 1.84 vs. Nϩ, 2.76 L; P Ͻ .001), and less plasma (N0, 2.07 vs. Nϩ, 2.93 U; P Ͻ .05), or blood (N0, 1.05 vs. Nϩ, 1.81 U; P Ͻ .05) transfusions were required. Hospital stay was similar (N0, 12.70 vs Nϩ, 16.50 days; P not significant [NS]). There was only one urologic complication in the nephrectomy group. There were no differences (P ϭ NS) in rates of delayed graft function (N0, 19.9%; Nϩ, 12.5%), acute rejections (N0, 25.5%; N0, 33.3%), chronic allograft dysfunction (N0, 15.8%; Nϩ, 28.6%). Graft function at 1 month as well as 1 and 5 years were comparable. Patient and graft survivals were similar at 1 and 5 years. There were no differences in the causes of graft loss or patient death. Conclusion. In patients with ADPKD native nephrectomy of massively enlarged kidneys may be safely performed during the transplant procedure with no repercussions on the length of hospital stay, graft short-and long-term function and patient survival. However the procedure eads to a longer operative time and greater need for fluids and blood products.

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Section: Discussionmentioning

confidence: 97%

Simultaneous Renal Transplantation and Native Nephrectomy in Patients With Autosomal-Dominant Polycystic Kidney Disease

Nunes¹,

Mota²,

Alves³

et al. 2007

Transplantation Proceedings

View full text Add to dashboard Cite

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“…As disadvantages of this method we may include the need to reposition the patient for access to the kidney on the opposite side, and the incision for the removal of the kidney. 3 In this case, we observed that one advantage of the procedure performed via transperitoneal access was the possibility of access to the two kidney units, with no need for repositioning the patient.…”

Section: Discussionmentioning

confidence: 70%

“…1 With regard to adult cystic disease, the role of ablative laparoscopy is mainly related to renal decortication surgery for the relief of pain and symptoms related to large kidney volumes (dyspepsia, respiratory restrictions). 3 It yields one-year symptom remission rates that vary from 80 to 92%. 1 Nephrectomy is indicated in cases of hardto-control hypertension, recurring pyelonephritis and substantial protein loss in the urine.…”

Section: Discussionmentioning

confidence: 99%

“…1 There are some situations in which nephrectomy is necessary in patients with kidney failure in its final stage, especially in cases of hard-to-control severe hypertension, recurring pyelonephritis, severe protein loss, 1,2,3 and enlarged kidney size causing respiratory or gastric discomfort. 3 Bilateral nephrectomy by conventional access is normally performed via bilateral lumbotomy, as well as through a median xiphopubic incision, with a high morbidity rate. 3 Our objective was to report on a case of hand-assisted bilateral laparoscopic nephrectomy, describing the technique and commenting on this surgical option.…”

Section: Introductionmentioning

confidence: 99%

“…3 Bilateral nephrectomy by conventional access is normally performed via bilateral lumbotomy, as well as through a median xiphopubic incision, with a high morbidity rate. 3 Our objective was to report on a case of hand-assisted bilateral laparoscopic nephrectomy, describing the technique and commenting on this surgical option.…”

Section: Introductionmentioning

confidence: 99%

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Hand-assisted bilateral nephrectomy in a patient with adult polycystic kidney disease

et al. 2002

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CONTEXT: Dominantly autosomal polycystic disease is characterized by multiple bilateral and non-functional cysts, which lead to progressive kidney failure. OBJECTIVE: Our objective was to report on a case of hand-assisted bilateral nephrectomy in a 28-year-old female patient with adult polycystic disease and recurring pyelonephritis in a kidney transplant program. CASE REPORT: A hand-assisted bilateral nephrectomy was performed through a supra-umbilical median incision of approximately 6 cm, and with 3 ports of 10 mm. The length of the surgery was 3 hours and 15 minutes. The kidneys were removed after the aspiration of some cysts through the supra-umbilical incision. Pain control was achieved via the use of analgesics. The blood loss during surgery was 160 ml. During the postoperative period, the patient developed right-side pneumothorax, which was drained with no further occurrence. This drain was kept in place for 48 hours. The length of hospitalization was 4 days.

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Robotic bilateral nephrectomy for large polycystic kidney disease

et al. 2023

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ObjectiveThis study aims to describe our technique and review our experience with synchronous robotic bilateral nephrectomy for large kidneys in ADPKD with the da Vinci XI and da Vinci Single Port platforms (Intuitive Surgical, Sunnyvale, CA).Materials and MethodsWe performed a retrospective review of all robotic bilateral nephrectomy cases from January 2020 to present at a high‐volume robotic single centre. Demographic data and perioperative details including preoperative CT scans, indication for nephrectomy and renal function were collected. We also collected post‐op course data and final specimen data details.ResultsFourteen cases were included. Patient demographics, indications for surgery and specimen data are outlined in Table 1. The largest kidney removed has a measurement of 32 cm in the largest dimension on preoperative imaging. Median operating time from incision to closure was 299 min (IQR 260, 339). Median estimated blood loss was 75 cc (IQR 50, 187.5). Two patients were transfused intraoperatively. Median pre‐ and post‐operative Hgb was 11.0 and 9.6, respectively. Median length of stay was 3 days (IQR 2, 3.5). There were no intraoperative complications and no open conversions. Post‐operative complications included one incisional hematoma and one superficial wound infection. One patient was admitted to the surgical ICU post operatively for ventilatory support. Two patients were readmitted within 30 days of surgery.ConclusionThe robotic approach to bilateral native nephrectomy for ADPKD should be considered when native nephrectomies are indicated. The operative times and outcomes are favourable compared with prior series, and this technique works even for very large kidneys.

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Laparoscopic Bilateral Synchronous Nephrectomy for Autosomal Dominant Polycystic Kidney Disease: The Initial Experience

Cited by 80 publications

References 15 publications

Simultaneous Renal Transplantation and Native Nephrectomy in Patients With Autosomal-Dominant Polycystic Kidney Disease

Simultaneous Renal Transplantation and Native Nephrectomy in Patients With Autosomal-Dominant Polycystic Kidney Disease

Hand-assisted bilateral nephrectomy in a patient with adult polycystic kidney disease

Robotic bilateral nephrectomy for large polycystic kidney disease

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