Laparoscopic Nephrectomy for Adult Polycystic Kidney Disease: Safety, Feasibility, and Early Outcomes

Williamson, A.; Paterson, Sureyya; Erolin, Caroline; Sweeney, Clare; Townell, N. H.; Nabi, Ghulam

doi:10.1089/end.2014.0311

Cited by 8 publications

(2 citation statements)

References 32 publications

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“…28 However, mortality after laparoscopic nephrectomy has been unclear in patients with ADPKD. 29,30 In our study, the 1-year overall survival rate after renal TAE was similar to that of patients without ADPKD and with stage 4 CKD undergoing radical nephrectomy for unilateral sporadic benign renal tumors. 31 Five patients underwent nephrectomy (four for renal cell carcinoma and one for severe renal cyst infection), two patients received renal transplantation, and five patients had repeat TAE within 1 year for abdominal pain and hematuria associated with cyst bleeding or RV re-enlargement (two patients initially received unilateral renal TAE and subsequently underwent TAE on the other side).…”

Section: Resultssupporting

confidence: 71%

Suitability of Patients with Autosomal Dominant Polycystic Kidney Disease for Renal Transcatheter Arterial Embolization

Suwabe

Ubara

Mise

et al. 2015

JASN

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In patients with autosomal dominant polycystic kidney disease (ADPKD), massive renal enlargement is a serious problem. Renal transcatheter arterial embolization (TAE) can reduce renal volume (RV), but effectiveness varies widely, and the reasons remain unclear. We investigated factors affecting renal volume reduction rate (RVRR) after renal TAE in all 449 patients with ADPKD who received renal TAE at Toranomon Hospital from January of 2006 to July of 2013, including 228 men and 221 women (mean age =57.069.1 years old). One year after renal TAE, the RVRR ranged from 3.9% to 84.8%, and the least squares mean RVRR calculated using a linear mixed model was 45.5% (95% confidence interval [95% CI], 44.2% to 46.8%). Multivariate analysis using the linear mixed model revealed that RVRR was affected by the presence of large cysts with wall thickening (regression coefficient [RC], 26.10; 95% CI, 29.04 to 23.16; P,0.001), age (RC, 20.82; 95% CI, 21.03 to 20.60; P,0.001), dialysis duration (RC, 20.10; 95% CI, 20.18 to 20.03; P,0.01), systolic BP (RC, 0.39; 95% CI, 0.19 to 0.59; P,0.001), and the number of microcoils used for renal TAE (RC, 1.35; 95% CI, 0.83 to 1.86; P,0.001). Significantly more microcoils were needed to achieve renal TAE in patients with younger age and shorter dialysis duration. In conclusion, cyst wall thickening had an important effect on cyst volume reduction. Renal TAE was more effective in patients who were younger, had shorter dialysis duration, or had hypertension, parameters that might associate with cyst wall stiffness and renal artery blood flow.

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Section: Resultssupporting

confidence: 71%

Suitability of Patients with Autosomal Dominant Polycystic Kidney Disease for Renal Transcatheter Arterial Embolization

Suwabe

Ubara

Mise

et al. 2015

JASN

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“…In 2014 Williamson et al 30 published an interesting review of the literature, including analysis of many of the series published up to then, covering a total of 293 patients who had undergone a laparoscopic nephrectomy. The conclusion of the review, however, is that the quality of the studies included is poor, hence it is difficult to decide in favor or against a change in surgical technique and in clinical practice based on level 3 or 4 evidence, and that superior quality studies are required to demonstrate that the technique can be generalized.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Nephrectomy for Massive Kidneys in Polycystic Kidney Disease

Collini

Benigni

Ruggieri

et al. 2021

JSLS

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Background and Objectives: Laparoscopic nephrectomy is now considered a feasible surgical approach, even for large kidneys. In the case of massive kidneys, laparoscopy can be problematic, so that some authors suggest an open approach. However, previous studies have shown that hand-assisted laparoscopic nephrectomy (HALN) may represent a useful compromise.We describe our hand-assisted laparoscopic technique for nephrectomy of large kidneys (> 2500 g) to encourage the use of laparoscopy for nephrectomy in autosomal dominant polycystic kidney disease.Methods: We retrospectively analyzed data from 26 nephrectomies in 17 patients who underwent HALN for ADPKD and compared them to a group of 22 nephrectomies in 18 patients with open surgical technique.Results: The duration of the procedure was significantly longer in the laparoscopic group, with a median of 180 minutes versus 90 minutes for the unilateral nephrectomies, and 240 minutes versus 122 minutes for the bilateral procedures. The median kidney weight in the open group was 2500 g (range 1300 -4500 g), while the median weight in the HALN group was 2375 g (range 1000 -4700 g). The median hospital stay was comparable. No significant differences were recorded in the intra-and postoperative complication rate. Conclusion:Hand-assisted laparoscopic nephrectomy can be considered a technique of choice for patients suffering from ADPKD requiring nephrectomy, also with massive kidneys weighing more than 3500 g. Compared to open nephrectomy, HALN can be performed safely, with reasonably longer operating times and without major complications, and offers a significant reduction in hospitalization time, pain and postoperative discomfort.

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Prise en charge de la polykystose rénale autosomique dominante avant transplantation rénale

Tillou

Timsit

Sallusto

et al. 2016

Progrès en Urologie

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Laparoscopic Nephrectomy for Adult Polycystic Kidney Disease: Safety, Feasibility, and Early Outcomes

Abstract: The quality of the included studies is poor, and it is difficult to argue for or against change in clinical practice because the evidence included is of level 3 and 4 only. Higher quality studies are needed to demonstrate that the technique is generalizable across all populations.

Cited by 8 publications

References 32 publications

Suitability of Patients with Autosomal Dominant Polycystic Kidney Disease for Renal Transcatheter Arterial Embolization

Suitability of Patients with Autosomal Dominant Polycystic Kidney Disease for Renal Transcatheter Arterial Embolization

Laparoscopic Nephrectomy for Massive Kidneys in Polycystic Kidney Disease

Prise en charge de la polykystose rénale autosomique dominante avant transplantation rénale

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