Living Donor Nephrectomy: <i>Complication Rates in 490 Consecutive Cases</i>

Blohmé, I; Fehrman, I; Nordén, Gunnela

doi:10.1080/00365599.1992.11690446

Cited by 71 publications

(31 citation statements)

References 15 publications

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“…The major complication rate was about 2%. 9,70 Alternative techniques have included using a midline or subcostal abdominal incision via the intraperitoneal approach. Since 1994, minimal invasive laparoscopic livingdonor nephrectomy has gradually become the preferred technique due to its multiple benefits: less pain, better cosmetic outcome, quicker convalescence, and fewer complications.…”

Section: Discussionmentioning

confidence: 99%

Untitled

Bremner²,

Han³

et al. 2016

Exp Clin Transplant

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Objectives: Laparoscopic living-donor nephrectomy is now widely used because of its many beneficial features. Currently, there are 2 major techniques: the laparoscopic intraperitoneal approach and the retroperitoneoscopic approach. There is no evidence to support one particular approach over another. Therefore, in this study, we conducted a systematic literature review with the aim of defining which technique is superior. Materials and Methods: The Embase, PubMed, and Cochrane literature databases were searched for English language articles published between January 1994 and January 2013 using the terms "laparoscopic donor nephrectomy," "retroperitoneoscopic donor nephrectomy," and "live donor nephrectomy." A metaanalysis was undertaken, and I 2 statistical analyses were used to describe the percentage of variation across studies due to heterogeneity rather than chance. Results: With the use of our selection criteria, 55 papers on the laparoscopic intraperitoneal approach and 6 papers on the retroperitoneoscopic approach were included in this study. We found significantly lower transfusion rate, fewer patients with delayed graft functions, less vessel injuries, and less conversion to open surgical procedure with the retroperitoneoscopic approach than with the laparoscopic intraperitoneal approach. Conclusions: From this review, a high degree of study heterogeneity was identified, suggesting an urgent need for consistency in reporting laparoscopic livingdonor nephrectomy. Results of the meta-analyses may define a better technique for the future. The retroperitoneoscopic approach may be better than the laparoscopic intraperitoneal approach with fewer complications and fewer patients with delayed graft function. Further study of laparoscopic living-donor nephrectomy is recommended to define a standard and thus to minimize the surgical morbidities.

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Section: Discussionmentioning

confidence: 99%

Untitled

Bremner²,

Han³

et al. 2016

Exp Clin Transplant

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“…Efectivamente, las claras ventajas de la técnica las vamos a encontrar en el donante; menor dolor postoperatorio, menos días de estancia hospitalaria, una más rápida incorporación a su vida normal y laboral y una mejor estética de las cicatrices 25. Tampoco debemos olvidar la morbilidad de la clásica lumbotomía, así como sus secuelas (infección, hernia, dolor crónico 26,27 ).. Podemos plantearnos si estas ventajas pueden ser suficientemente importantes a la hora de que el donante se incline por aceptar la cirugía. Indudablemente la laparoscopia no va a hacer que todos los donantes a los que se la planteemos lo acepten, pero si hemos tenido casos en nuestra serie de pacientes cuyo trabajo autónomo no les permitía estar mucho tiempo de baja y la técnica mínimamente invasiva les ha hecho decidirse.…”

Section: Discussionunclassified

Donante vivo renal: Experiencia de cirugía abierta y laparoscópica. Hospital La Paz

et al. 2009

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ResumenLa extracción renal laparóscopica es una técnica escasamente implantada en nuestro país, debido principalmente a la dificultad técnica que supone y a la gran cantidad de donante cadáver que encontramos en nuestro medio. Presentamos y analizamos nuestra serie de donante vivo abierto y laparoscópico desde 1984. Material y Métodos: Desde 1984 hasta 2007 se han realizado 84 extracciones renales de donante vivo; 64 por cirugía abierta, 20 laparoscópicas. El abordaje transperitoneal ha sido el elegido en el caso de la laparoscopia y la lumbotomía en la abierta. Resultados: En la técnica abierta el tiempo quirúrgico medio es de 112 min (70-155), el tiempo medio de isquemia caliente es de 20 segundos (15-47) y la estancia media es de 4,8 días (3-9). En los casos realizados por laparoscopia, el tiempo quirúrgico medio es de 146 min (90-210), el tiempo de isquemia caliente es de 3 min y 15 seg (2-3,25) y la estancia media es de 3,4 días (2-9). Conclusiones: El abordaje laparoscópico es una técnica que no está exenta de riesgos y que no deben ser despreciados. Debe ser realizado por equipos con experiencia en cirugía renal laparoscópica. En lo referente al riñón obtenido de donante vivo, sin duda se trata de una magnífica solución para pacientes en estado de insuficiencia renal crónica. Es un recurso que deben ofrecer los principales hospitales de nuestro país. 4,8 days (3-9). Laparoscopic cases, the operating time is 146 min (90-210), ischaemia time 3 min 15 sec (2-3,25 min) and postoperative hospital stay 3,4 days (2-9). Conclusions: The laparoscopic live donor nephrectomy is a difficult and demanding technique. It should be done by experienced team in laparoscopic renal surgery. The kidney from a live donor is a very good alternative for the cronic renal failure. It should be offered in our main hospitals.

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“…For the open procedure, we use horizontal incision a few centimeters above the umbilicus from the median line and 15-20 centimeters laterally [2]. The patient is positioned on their back and the kidney is dissected retroperitoneally.…”

Section: Discussionmentioning

confidence: 99%

Experience with laparoscopic donor nephrectomy at a European transplant centre

Østraat

Lönnroth

Olausson

et al. 2000

Transplant International

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Renal grafts from live donors represent an important source for transplantation of end stage renal failure patients. Postoperative short-and long-term comfort is essential. Laparoscopic nephrectomy was performed in 22 cases. The left kidney was preferred for optimal length of the vessels. One procedure was converted to open surgery because of venous bleeding. Warm ischemia time varied between 4 and 7.5 min. Urine production started peroperatively in all cases, and the renal function was excellent. Shoulder pain 1-3 days postoperatively was observed in seven patients; the rest were comfortable on peroral non-opioid analgesia. The patients were discharged at postoperative days 3-9, and returned to work 2 4 weeks later as compared to 443 weeks after open nephrectomy at our centre. Laparoscopic donor nephrectomy in the hands of experienced laparoscopic and transplant surgeons is a safe operation with less discomfort to the living kidney donor.

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Living Donor Nephrectomy: Complication Rates in 490 Consecutive Cases

Cited by 71 publications

References 15 publications

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Donante vivo renal: Experiencia de cirugía abierta y laparoscópica. Hospital La Paz

Experience with laparoscopic donor nephrectomy at a European transplant centre

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