Laparoscopic living donor right nephrectomy: Assessment of outcome and association of BMI to length of right renal vein

Vũ, Lê Nguyên; Nghia, Nguyen Quang; Thanh, Do Tat; Giang, Tran Bình; Nga, Vu Thi; Bui, L.M.; Chu, Dinh‐Toi

doi:10.1016/j.acuroe.2019.05.009

Cited by 5 publications

(3 citation statements)

References 19 publications

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“…Until 1994, Kitano firstly described the efficacy of laparoscopy gastrectomy (LG) in the case of early stage carcinoma in the antrum of the stomach [6]. Then, the employment of LG for gastric cancer has achieved rapid development and popularities in past decades due to minimal invasion, less blood loss, less time of using analgesic requirement and quicker recovery [7][8][9][10]. Another benefit of laparoscopic surgery is the capacity to observe the surgical field in a magnified view, which could help surgeons with more meticulous dissection of lymph nodes which is important to patient's prognosis [11].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic versus open gastrectomy for gastric cancer

et al. 2020

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Background:Compared with open gastrectomy (OG), laparoscopic gastrectomy (LG) for gastric cancer has achieved rapid development and popularities in the past decades. However, lack of comprehensive analysis in longterm oncological outcomes such as recurrence and mortality hinder its full support as a valid procedure. Therefore, there are still debates on whether one of these options is superior. Aim: To evaluate the primary and secondary outcomes of laparoscopic versus open gastrectomy for gastric cancer patients Methods: Two authors independently extracted study data. Risk ratio (RR) with 95% confidence interval (CI) was calculated for binary outcomes, mean difference (MD) or the standardized mean difference (SMD) with 95% CI for continuous outcomes, and the hazard ratio (HR) for time-to-event outcomes. Review Manager 5.3 and STATA software were used for the meta-analysis.Results: Seventeen randomized controlled trials (RCTs) involving 5204 participants were included in this metaanalysis. There were no differences in the primary outcomes including the number of lymph nodes harvested during operation, severe complications, short-term and long-term recurrence, and mortality. As for secondary outcomes, compared with the OG group, longer operative time was required for patients in the LG group (MD = 58.80 min, 95% CI = [45.80, 71.81], P < 0.001), but there were less intraoperative blood loss (MD = − 54.93 ml, 95% CI = [− 81.60, − 28.26], P < 0.001), less analgesic administration (frequency: MD = − 1.73, 95% CI = [− 2.21, − 1.24], P < 0.001; duration: MD = − 1.26 days, 95% CI = [− 1.40, − 1.12], P < 0.001), shorter hospital stay (MD = − 1.37 days, 95% CI = [− 2.05, − 0.70], P < 0.001), shorter time to first flatus (MD = − 0.58 days, 95% CI = [− 0.79, − 0.37], P < 0.001), ambulation (MD = − 0.50 days, 95% CI = [− 0.90, − 0.09], P = 0.02) and oral intake (MD = − 0.64 days, 95% CI = [− 1.24, − 0.03], P < 0.04), and less total complications (RR = 0.81, 95% CI = [0.71, 0.93], P = 0.003) in the OG group. There was no difference in blood transfusions (number, quantity) between these two groups. Subgroup analysis, sensitivity analysis, and the adjustment of Duval's trim and fill methods for publication bias did not change the conclusions. Conclusion:LG was comparable to OG in the primary outcomes and had some advantages in secondary outcomes for gastric cancer patients.LG is superior to OG for gastric cancer patients.

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Section: Introductionmentioning

confidence: 99%

Laparoscopic versus open gastrectomy for gastric cancer

et al. 2020

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“…A few studies reported the artery length, but only one study did so for clips (mean artery length 4.5 cm) [33]. Among the studies that reported this information for staplers [34][35][36], the artery length ranged from 2.1 to 3.7 cm. Further research is needed to define the role of polymer clips in some specific situations, especially in cases of vascular complexity, e.g., multiple renal arteries or shorter vascular length.…”

Section: Discussionmentioning

confidence: 99%

Vascular closure devices in living‐donor nephrectomy: a much‐needed systematic review and meta‐analysis focusing on safety

et al. 2023

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ObjectiveTo assess the safety of vascular closure devices in living‐donor nephrectomy (LDN), as staplers and non‐transfixion techniques (polymer locking and metal clips) are the methods employed to secure the renal vessels during laparoscopic and robotic LDN, but the use of clips has come into question since the United States Food and Drug Administration and manufacturers issued a contraindication.MethodsA systematic review and meta‐analysis were conducted to assess the safety of vascular closure devices (International Prospective Register of Systematic Reviews [PROSPERO] registration: CRD42022364349). The PubMed, Scopus, the Excerpta Medica dataBASE (EMBASE), and the Literatura Latino‐Americana e do Caribe em Ciências da Saúde (LILACS) databases were searched in September 2022. For comparative and non‐comparative studies, incidence estimates and odds ratios (ORs), respectively, for the main variables regarding safety of vascular closure devices were pooled by using random effects meta‐analyses. Quality assessment of the included comparative studies was conducted using the Risk Of Bias In Non‐randomised Studies of Interventions (ROBINS‐I) tool.ResultsOf the 863 articles obtained, data were retrieved from 44 studies, which included 42 902 patients. In non‐comparative studies, the pooled estimate rates for device failure, severe haemorrhage rate, conversion to open surgery, and mortality were similar for both clips and staplers. Regarding the meta‐analyses for comparative studies (three studies), there were no significant differences between the two groups for the severe haemorrhage rate (OR 0.57, 95% confidence interval [CI] 0.18–1.75; P = 0.33), conversion to open surgery (OR 0.35, 95% CI 0.08–1.54; P = 0.16), or death rate (OR 3.64, 95% CI 0.47–28.45; P = 0.22). Based on weak evidence, device failure was lower in the polymer clip group (OR 0.41, 95% CI 0.23–0.75; P = 0.00).ConclusionsThis study has confirmed that there is no evidence for the superiority of any vascular closure device in terms of safety in LDN. Standardised recommendations for vascular control in this context should be carefully designed and prospectively evaluated.

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“…An explanation for this could be that donor nephrectomy is likely to be performed more often on the left side than on the right side. At our institution, right donor nephrectomy is performed routinely [ 14 ] and is similar to the corresponding procedure on the left side. Furthermore, laparoscopy seems to cause a higher risk of lymphatic fistula than laparotomy [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Right lumbar lymph trunk injury after right laparoscopic donor nephrectomy: a case report

Dung

Vũ

et al. 2023

Korean J Transplant

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Laparoscopic donor nephrectomy (LDN) is increasingly popular because of its advantages over open surgery. Chyle leak after donor nephrectomy is a rare but potentially lethal complication if not treated appropriately. We describe a case of a 43-year-old female patient with no remarkable history who presented a chyle leak on day 2 after right transperitoneal LDN. Since conservative treatment failed, the patient underwent magnetic resonance imaging (MRI) and intranodal lipiodol lymphangiography, which confirmed the chyle leak from the right lumbar lymph trunk into the right renal fossa. The chyle leak was percutaneously embolized twice, on postoperative day (POD) 5 and POD 10, by a mixture of N-butyl-2-cyanoacrylate and lipiodol. The drainage fluid decreased significantly after the second embolization. The subhepatic drainage tube was withdrawn on POD 14, and the patient was discharged on POD 17. MRI lymphangiography and intranodal lipiodol lymphangiography effectively identified the chyle leak point. Percutaneous embolization seems to be a safe, effective method for treating high-output chyle leaks.

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Laparoscopic living donor right nephrectomy: Assessment of outcome and association of BMI to length of right renal vein

Cited by 5 publications

References 19 publications

Laparoscopic versus open gastrectomy for gastric cancer

Laparoscopic versus open gastrectomy for gastric cancer

Vascular closure devices in living‐donor nephrectomy: a much‐needed systematic review and meta‐analysis focusing on safety

Right lumbar lymph trunk injury after right laparoscopic donor nephrectomy: a case report

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