Minimally Invasive Surgery Is Feasible in Patients with Liver and Kidney Transplantation

Hsu, Da Wen; Chang, Chun Ming; Hsu, Chun Shuo; Yin, Wen Yao

doi:10.12659/aot.922602

Cited by 1 publication

(1 citation statement)

References 26 publications

(29 reference statements)

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“…The use of minimally invasive surgery, including laparoscopic[ 24 ] and robotic surgery[ 25 ], has been documented to play an important role in the management of patients with acute abdomen, including transplantation patients. The additional advantage in the latter case is that there is no need for perioperative immunosuppressant regulation, as it is anticipated that the patients who undergo minimally invasive surgery have a shorter time to oral feeding postoperatively after these procedures.…”

Section: Managementmentioning

confidence: 99%

Critical considerations for the management of acute abdomen in transplant patients

Pavlidis,

Katsanos,

Kofinas

et al. 2024

World J Transplant

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The number of solid organ transplantations performed annually is increasing and are increasing in the following order: Kidney, liver, heart, lung, pancreas, small bowel, and uterine transplants. However, the outcomes of transplants are improving (organ survival > 90% after the 1st year). Therefore, there is a high probability that a general surgeon will be faced with the management of a transplant patient with acute abdomen. Surgical problems in immunocompromised patients may not only include graft-related problems but also nongraft-related problems. The perioperative regulation of immunosuppression, the treatment of accompanying problems of immunosuppression, the administration of cortisol and, above all, the realization of a rapidly deteriorating situation and the accurate evaluation and interpretation of clinical manifestations are particularly important in these patients. The perioperative assessment and preparation includes evaluation of the patient’s cardiovascular system and determining if the patient has hypertension or suppression of the hypothalamic-pituitary-adrenal axis, or if the patient has had any coagulation mechanism abnormalities or thromboembolic episodes. Immunosuppression in transplant patients is associated with the use of calcineurin inhibitors, corticosteroids, and antiproliferation agents. Many times, the clinical picture is atypical, resulting in delays in diagnosis and treatment and leading to increased morbidity and mortality. Multidetector computed tomography is of utmost importance for early diagnosis and management. Transplant recipients are prone to infections, especially specific infections caused by cytomegalovirus and Clostridium difficile , and they are predisposed to intraoperative or postoperative complications that require great care and vigilance. It is necessary to follow evidence-based therapeutic protocols. Thus, it is required that the clinician choose the correct therapeutic plan for the patient (conservative, emergency open surgery or minimally invasive surgery, including laparoscopic or even robotic surgery).

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Section: Managementmentioning

confidence: 99%