A comparison of laparoendoscopic single-site surgery versus conventional procedures for laparoscopic donor nephrectomy: a Japanese multi-institutional retrospective study
Purpose Laparoendoscopic single-site donor nephrectomy (LESSDN) is a feasible and effective procedure because of its non-invasiveness and better cosmetic outcomes. However, there have been few multi-institutional studies conducted by multiple surgeons on LESSDN. We retrospectively compared the clini...
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| Veröffentlicht in: | Surgical endoscopy 2020-08, Vol.34 (8), p.3424-3434 |
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| creator | Inoue, Takamitsu Miura, Masayoshi Yanishi, Masaaki Furukawa, Junya Sato, Fuminori Nitta, Masahiro Yoshimura, Koji Hagiuda, Jun Shinoda, Kazunobu Kobayashi, Takashi Miyajima, Akira Nakagawa, Ken Oya, Mototsugu Ogawa, Osamu Mimata, Hiromitsu Kanayama, Hiro-omi Fujisawa, Masato Terachi, Toshiro Matsuda, Tadashi Habuchi, Tomonori |
| description | Purpose
Laparoendoscopic single-site donor nephrectomy (LESSDN) is a feasible and effective procedure because of its non-invasiveness and better cosmetic outcomes. However, there have been few multi-institutional studies conducted by multiple surgeons on LESSDN. We retrospectively compared the clinical data and outcomes between LESSDN and conventional laparoscopic donor nephrectomy (LDN) at multiple institutes in Japan.
Materials and methods
From 2009 to 2015, the clinical data of 223 donors who underwent LESSDN and 151 donors who underwent LDN were collected from 10 institutes. All LESSDNs were performed transperitoneally, whereas LDNs were performed transperitoneally (P-LDN) in 75 patients and retroperitoneally (R-LDN) in 76 patients.
Results
In the LESSDN group, the single-incision site was pararectal in 155 (69.5%) patients and umbilical in 65 (29.1%) patients. Multiple surgeons (one to eight per institute) performed the LESSDN. No significant differences were observed between the three groups regarding estimated blood loss and warm ischemic time. The operative time was significantly shorter in the LESSDN group than in the R-LDN group (
p
= 0.018). No significant differences were observed regarding the rates of blood transfusion, open conversion, visceral injuries, and postoperative complications. Furthermore, no significant differences were observed regarding the dose of analgesic and the rate of delayed graft function. One patient required open conversion due to injury to the renal artery. Selection of LESS procedure was not an independent risk factor for the median serum creatinine level of above 1.27 mg/dL in recipients at 1 year after kidney transplantation.
Conclusion
The results showed the technical feasibility of LESSDN compared with the standard LDNs in a multi-institutional and multi-surgeon setting. A few observed non-negligible complications and the significantly higher levels of serum creatinine in patients who underwent LESSDN indicate that this procedure should be employed cautiously when performed by surgeons without ample experience in performing LESS procedures. |
| doi_str_mv | 10.1007/s00464-019-07119-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2296655496</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2295830637</sourcerecordid><originalsourceid>FETCH-LOGICAL-c441t-63f9358063ec14e9ac276ac41c45354f5abb7d7c401a079d82507774f3abaf213</originalsourceid><addsrcrecordid>eNp9kc1u1DAUhS1ERYfCC7BAltiwCfgv8ZhdVRXaqlI3sI48zk1xldjBPyPNK_UpuXQCSCzY2LL9nXPv9SHkDWcfOGP6Y2ZMdaph3DRMc1zNM7LhSopGCL59TjbMSNYIbdQpeZnzA0Pe8PYFOZW8VUZIvSGP59TFebHJ5xhoHOlk8RAhDDG7uHhHsw_3EzTZF6C5pntIB7qHlGtGZdhDKD4GO9ElRQdDTZDpGNPqs3oMMeBVgOV7AlfifPhELb1BIkAGOtep-MaHXHypq1uCguoFab_HuqUOh1fkZLRThtfrfka-fb78enHV3N59ub44v22cUrw0nRyNbLesk-C4AmOd0J11ijvVylaNrd3t9KCdYtwybYataJnWWo3S7uwouDwj74--ONGPCrn0s88Opgm7jTX3Qpiua_EDO0Tf_YM-xJqw_yeq3UrsQiMljpTDkXKCsV-Sn2069Jz1v5Lsj0n2mGT_lGRvUPR2ta67GYY_kt_RISCPQMangLH8rf0f258nGK5J</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2295830637</pqid></control><display><type>article</type><title>A comparison of laparoendoscopic single-site surgery versus conventional procedures for laparoscopic donor nephrectomy: a Japanese multi-institutional retrospective study</title><source>SpringerLink Journals</source><creator>Inoue, Takamitsu ; Miura, Masayoshi ; Yanishi, Masaaki ; Furukawa, Junya ; Sato, Fuminori ; Nitta, Masahiro ; Yoshimura, Koji ; Hagiuda, Jun ; Shinoda, Kazunobu ; Kobayashi, Takashi ; Miyajima, Akira ; Nakagawa, Ken ; Oya, Mototsugu ; Ogawa, Osamu ; Mimata, Hiromitsu ; Kanayama, Hiro-omi ; Fujisawa, Masato ; Terachi, Toshiro ; Matsuda, Tadashi ; Habuchi, Tomonori</creator><creatorcontrib>Inoue, Takamitsu ; Miura, Masayoshi ; Yanishi, Masaaki ; Furukawa, Junya ; Sato, Fuminori ; Nitta, Masahiro ; Yoshimura, Koji ; Hagiuda, Jun ; Shinoda, Kazunobu ; Kobayashi, Takashi ; Miyajima, Akira ; Nakagawa, Ken ; Oya, Mototsugu ; Ogawa, Osamu ; Mimata, Hiromitsu ; Kanayama, Hiro-omi ; Fujisawa, Masato ; Terachi, Toshiro ; Matsuda, Tadashi ; Habuchi, Tomonori ; LESS and RPS Research Group in Japanese Society of Endourology ; LESS and RPS Research Group in Japanese Society of Endourology</creatorcontrib><description>Purpose
Laparoendoscopic single-site donor nephrectomy (LESSDN) is a feasible and effective procedure because of its non-invasiveness and better cosmetic outcomes. However, there have been few multi-institutional studies conducted by multiple surgeons on LESSDN. We retrospectively compared the clinical data and outcomes between LESSDN and conventional laparoscopic donor nephrectomy (LDN) at multiple institutes in Japan.
Materials and methods
From 2009 to 2015, the clinical data of 223 donors who underwent LESSDN and 151 donors who underwent LDN were collected from 10 institutes. All LESSDNs were performed transperitoneally, whereas LDNs were performed transperitoneally (P-LDN) in 75 patients and retroperitoneally (R-LDN) in 76 patients.
Results
In the LESSDN group, the single-incision site was pararectal in 155 (69.5%) patients and umbilical in 65 (29.1%) patients. Multiple surgeons (one to eight per institute) performed the LESSDN. No significant differences were observed between the three groups regarding estimated blood loss and warm ischemic time. The operative time was significantly shorter in the LESSDN group than in the R-LDN group (
p
= 0.018). No significant differences were observed regarding the rates of blood transfusion, open conversion, visceral injuries, and postoperative complications. Furthermore, no significant differences were observed regarding the dose of analgesic and the rate of delayed graft function. One patient required open conversion due to injury to the renal artery. Selection of LESS procedure was not an independent risk factor for the median serum creatinine level of above 1.27 mg/dL in recipients at 1 year after kidney transplantation.
Conclusion
The results showed the technical feasibility of LESSDN compared with the standard LDNs in a multi-institutional and multi-surgeon setting. A few observed non-negligible complications and the significantly higher levels of serum creatinine in patients who underwent LESSDN indicate that this procedure should be employed cautiously when performed by surgeons without ample experience in performing LESS procedures.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-019-07119-9</identifier><identifier>PMID: 31549237</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdominal Surgery ; Endoscopy ; Gastroenterology ; Gynecology ; Hepatology ; Hospitals ; Kidney transplants ; Laparoscopy ; Medicine ; Medicine & Public Health ; Patient satisfaction ; Proctology ; Surgeons ; Surgery ; Transplants & implants ; University graduates ; Urology</subject><ispartof>Surgical endoscopy, 2020-08, Vol.34 (8), p.3424-3434</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2019</rights><rights>Springer Science+Business Media, LLC, part of Springer Nature 2019.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c441t-63f9358063ec14e9ac276ac41c45354f5abb7d7c401a079d82507774f3abaf213</citedby><cites>FETCH-LOGICAL-c441t-63f9358063ec14e9ac276ac41c45354f5abb7d7c401a079d82507774f3abaf213</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-019-07119-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-019-07119-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31549237$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Inoue, Takamitsu</creatorcontrib><creatorcontrib>Miura, Masayoshi</creatorcontrib><creatorcontrib>Yanishi, Masaaki</creatorcontrib><creatorcontrib>Furukawa, Junya</creatorcontrib><creatorcontrib>Sato, Fuminori</creatorcontrib><creatorcontrib>Nitta, Masahiro</creatorcontrib><creatorcontrib>Yoshimura, Koji</creatorcontrib><creatorcontrib>Hagiuda, Jun</creatorcontrib><creatorcontrib>Shinoda, Kazunobu</creatorcontrib><creatorcontrib>Kobayashi, Takashi</creatorcontrib><creatorcontrib>Miyajima, Akira</creatorcontrib><creatorcontrib>Nakagawa, Ken</creatorcontrib><creatorcontrib>Oya, Mototsugu</creatorcontrib><creatorcontrib>Ogawa, Osamu</creatorcontrib><creatorcontrib>Mimata, Hiromitsu</creatorcontrib><creatorcontrib>Kanayama, Hiro-omi</creatorcontrib><creatorcontrib>Fujisawa, Masato</creatorcontrib><creatorcontrib>Terachi, Toshiro</creatorcontrib><creatorcontrib>Matsuda, Tadashi</creatorcontrib><creatorcontrib>Habuchi, Tomonori</creatorcontrib><creatorcontrib>LESS and RPS Research Group in Japanese Society of Endourology</creatorcontrib><creatorcontrib>LESS and RPS Research Group in Japanese Society of Endourology</creatorcontrib><title>A comparison of laparoendoscopic single-site surgery versus conventional procedures for laparoscopic donor nephrectomy: a Japanese multi-institutional retrospective study</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Purpose
Laparoendoscopic single-site donor nephrectomy (LESSDN) is a feasible and effective procedure because of its non-invasiveness and better cosmetic outcomes. However, there have been few multi-institutional studies conducted by multiple surgeons on LESSDN. We retrospectively compared the clinical data and outcomes between LESSDN and conventional laparoscopic donor nephrectomy (LDN) at multiple institutes in Japan.
Materials and methods
From 2009 to 2015, the clinical data of 223 donors who underwent LESSDN and 151 donors who underwent LDN were collected from 10 institutes. All LESSDNs were performed transperitoneally, whereas LDNs were performed transperitoneally (P-LDN) in 75 patients and retroperitoneally (R-LDN) in 76 patients.
Results
In the LESSDN group, the single-incision site was pararectal in 155 (69.5%) patients and umbilical in 65 (29.1%) patients. Multiple surgeons (one to eight per institute) performed the LESSDN. No significant differences were observed between the three groups regarding estimated blood loss and warm ischemic time. The operative time was significantly shorter in the LESSDN group than in the R-LDN group (
p
= 0.018). No significant differences were observed regarding the rates of blood transfusion, open conversion, visceral injuries, and postoperative complications. Furthermore, no significant differences were observed regarding the dose of analgesic and the rate of delayed graft function. One patient required open conversion due to injury to the renal artery. Selection of LESS procedure was not an independent risk factor for the median serum creatinine level of above 1.27 mg/dL in recipients at 1 year after kidney transplantation.
Conclusion
The results showed the technical feasibility of LESSDN compared with the standard LDNs in a multi-institutional and multi-surgeon setting. A few observed non-negligible complications and the significantly higher levels of serum creatinine in patients who underwent LESSDN indicate that this procedure should be employed cautiously when performed by surgeons without ample experience in performing LESS procedures.</description><subject>Abdominal Surgery</subject><subject>Endoscopy</subject><subject>Gastroenterology</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Hospitals</subject><subject>Kidney transplants</subject><subject>Laparoscopy</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Patient satisfaction</subject><subject>Proctology</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Transplants & implants</subject><subject>University graduates</subject><subject>Urology</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kc1u1DAUhS1ERYfCC7BAltiwCfgv8ZhdVRXaqlI3sI48zk1xldjBPyPNK_UpuXQCSCzY2LL9nXPv9SHkDWcfOGP6Y2ZMdaph3DRMc1zNM7LhSopGCL59TjbMSNYIbdQpeZnzA0Pe8PYFOZW8VUZIvSGP59TFebHJ5xhoHOlk8RAhDDG7uHhHsw_3EzTZF6C5pntIB7qHlGtGZdhDKD4GO9ElRQdDTZDpGNPqs3oMMeBVgOV7AlfifPhELb1BIkAGOtep-MaHXHypq1uCguoFab_HuqUOh1fkZLRThtfrfka-fb78enHV3N59ub44v22cUrw0nRyNbLesk-C4AmOd0J11ijvVylaNrd3t9KCdYtwybYataJnWWo3S7uwouDwj74--ONGPCrn0s88Opgm7jTX3Qpiua_EDO0Tf_YM-xJqw_yeq3UrsQiMljpTDkXKCsV-Sn2069Jz1v5Lsj0n2mGT_lGRvUPR2ta67GYY_kt_RISCPQMangLH8rf0f258nGK5J</recordid><startdate>20200801</startdate><enddate>20200801</enddate><creator>Inoue, Takamitsu</creator><creator>Miura, Masayoshi</creator><creator>Yanishi, Masaaki</creator><creator>Furukawa, Junya</creator><creator>Sato, Fuminori</creator><creator>Nitta, Masahiro</creator><creator>Yoshimura, Koji</creator><creator>Hagiuda, Jun</creator><creator>Shinoda, Kazunobu</creator><creator>Kobayashi, Takashi</creator><creator>Miyajima, Akira</creator><creator>Nakagawa, Ken</creator><creator>Oya, Mototsugu</creator><creator>Ogawa, Osamu</creator><creator>Mimata, Hiromitsu</creator><creator>Kanayama, Hiro-omi</creator><creator>Fujisawa, Masato</creator><creator>Terachi, Toshiro</creator><creator>Matsuda, Tadashi</creator><creator>Habuchi, Tomonori</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20200801</creationdate><title>A comparison of laparoendoscopic single-site surgery versus conventional procedures for laparoscopic donor nephrectomy: a Japanese multi-institutional retrospective study</title><author>Inoue, Takamitsu ; Miura, Masayoshi ; Yanishi, Masaaki ; Furukawa, Junya ; Sato, Fuminori ; Nitta, Masahiro ; Yoshimura, Koji ; Hagiuda, Jun ; Shinoda, Kazunobu ; Kobayashi, Takashi ; Miyajima, Akira ; Nakagawa, Ken ; Oya, Mototsugu ; Ogawa, Osamu ; Mimata, Hiromitsu ; Kanayama, Hiro-omi ; Fujisawa, Masato ; Terachi, Toshiro ; Matsuda, Tadashi ; Habuchi, Tomonori</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c441t-63f9358063ec14e9ac276ac41c45354f5abb7d7c401a079d82507774f3abaf213</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Abdominal Surgery</topic><topic>Endoscopy</topic><topic>Gastroenterology</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Hospitals</topic><topic>Kidney transplants</topic><topic>Laparoscopy</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Patient satisfaction</topic><topic>Proctology</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>Transplants & implants</topic><topic>University graduates</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Inoue, Takamitsu</creatorcontrib><creatorcontrib>Miura, Masayoshi</creatorcontrib><creatorcontrib>Yanishi, Masaaki</creatorcontrib><creatorcontrib>Furukawa, Junya</creatorcontrib><creatorcontrib>Sato, Fuminori</creatorcontrib><creatorcontrib>Nitta, Masahiro</creatorcontrib><creatorcontrib>Yoshimura, Koji</creatorcontrib><creatorcontrib>Hagiuda, Jun</creatorcontrib><creatorcontrib>Shinoda, Kazunobu</creatorcontrib><creatorcontrib>Kobayashi, Takashi</creatorcontrib><creatorcontrib>Miyajima, Akira</creatorcontrib><creatorcontrib>Nakagawa, Ken</creatorcontrib><creatorcontrib>Oya, Mototsugu</creatorcontrib><creatorcontrib>Ogawa, Osamu</creatorcontrib><creatorcontrib>Mimata, Hiromitsu</creatorcontrib><creatorcontrib>Kanayama, Hiro-omi</creatorcontrib><creatorcontrib>Fujisawa, Masato</creatorcontrib><creatorcontrib>Terachi, Toshiro</creatorcontrib><creatorcontrib>Matsuda, Tadashi</creatorcontrib><creatorcontrib>Habuchi, Tomonori</creatorcontrib><creatorcontrib>LESS and RPS Research Group in Japanese Society of Endourology</creatorcontrib><creatorcontrib>LESS and RPS Research Group in Japanese Society of Endourology</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Inoue, Takamitsu</au><au>Miura, Masayoshi</au><au>Yanishi, Masaaki</au><au>Furukawa, Junya</au><au>Sato, Fuminori</au><au>Nitta, Masahiro</au><au>Yoshimura, Koji</au><au>Hagiuda, Jun</au><au>Shinoda, Kazunobu</au><au>Kobayashi, Takashi</au><au>Miyajima, Akira</au><au>Nakagawa, Ken</au><au>Oya, Mototsugu</au><au>Ogawa, Osamu</au><au>Mimata, Hiromitsu</au><au>Kanayama, Hiro-omi</au><au>Fujisawa, Masato</au><au>Terachi, Toshiro</au><au>Matsuda, Tadashi</au><au>Habuchi, Tomonori</au><aucorp>LESS and RPS Research Group in Japanese Society of Endourology</aucorp><aucorp>LESS and RPS Research Group in Japanese Society of Endourology</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A comparison of laparoendoscopic single-site surgery versus conventional procedures for laparoscopic donor nephrectomy: a Japanese multi-institutional retrospective study</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2020-08-01</date><risdate>2020</risdate><volume>34</volume><issue>8</issue><spage>3424</spage><epage>3434</epage><pages>3424-3434</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>Purpose
Laparoendoscopic single-site donor nephrectomy (LESSDN) is a feasible and effective procedure because of its non-invasiveness and better cosmetic outcomes. However, there have been few multi-institutional studies conducted by multiple surgeons on LESSDN. We retrospectively compared the clinical data and outcomes between LESSDN and conventional laparoscopic donor nephrectomy (LDN) at multiple institutes in Japan.
Materials and methods
From 2009 to 2015, the clinical data of 223 donors who underwent LESSDN and 151 donors who underwent LDN were collected from 10 institutes. All LESSDNs were performed transperitoneally, whereas LDNs were performed transperitoneally (P-LDN) in 75 patients and retroperitoneally (R-LDN) in 76 patients.
Results
In the LESSDN group, the single-incision site was pararectal in 155 (69.5%) patients and umbilical in 65 (29.1%) patients. Multiple surgeons (one to eight per institute) performed the LESSDN. No significant differences were observed between the three groups regarding estimated blood loss and warm ischemic time. The operative time was significantly shorter in the LESSDN group than in the R-LDN group (
p
= 0.018). No significant differences were observed regarding the rates of blood transfusion, open conversion, visceral injuries, and postoperative complications. Furthermore, no significant differences were observed regarding the dose of analgesic and the rate of delayed graft function. One patient required open conversion due to injury to the renal artery. Selection of LESS procedure was not an independent risk factor for the median serum creatinine level of above 1.27 mg/dL in recipients at 1 year after kidney transplantation.
Conclusion
The results showed the technical feasibility of LESSDN compared with the standard LDNs in a multi-institutional and multi-surgeon setting. A few observed non-negligible complications and the significantly higher levels of serum creatinine in patients who underwent LESSDN indicate that this procedure should be employed cautiously when performed by surgeons without ample experience in performing LESS procedures.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>31549237</pmid><doi>10.1007/s00464-019-07119-9</doi><tpages>11</tpages></addata></record> |
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| subjects | Abdominal Surgery Endoscopy Gastroenterology Gynecology Hepatology Hospitals Kidney transplants Laparoscopy Medicine Medicine & Public Health Patient satisfaction Proctology Surgeons Surgery Transplants & implants University graduates Urology |
| title | A comparison of laparoendoscopic single-site surgery versus conventional procedures for laparoscopic donor nephrectomy: a Japanese multi-institutional retrospective study |
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