Laparoscopic versus Conventional Live Donor Nephrectomy: Experience in a Community Transplant Program
Fifty-nine consecutive patients underwent live donor nephrectomy for transplantation. Twenty-nine patients (Group I) had open kidney procurement, and 30 patients (Group II) had laparoscopic procurement. The mean operative time in Group I was 2:30 hours (range 1:55–2:59), whereas in Group II it was 3...
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| Veröffentlicht in: | The American surgeon 2001-04, Vol.67 (4), p.342-345 |
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| creator | Hawasli, Abdelkader Boutt, Anthony Cousins, Geoffrey Schervish, Edward Oh, Henry |
| description | Fifty-nine consecutive patients underwent live donor nephrectomy for transplantation. Twenty-nine patients (Group I) had open kidney procurement, and 30 patients (Group II) had laparoscopic procurement. The mean operative time in Group I was 2:30 hours (range 1:55–2:59), whereas in Group II it was 3:01 hours (1:54–5:21). All kidneys functioned immediately after transplantation. The average warm ischemia time was not calculated in Group I; it was 3.9 minutes (2–15) in Group II. Intraoperative complications occurred in two patients in Group II. One patient had bleeding from an accessory renal artery. The second patient had a tear in the splenic capsule. No ureteral complications occurred in either group. Postoperatively one patient in Group I developed incisional hernia, one developed pneumothorax, and two developed atelectasis. In Group II one patient developed pancreatitis, one developed flank ecchymosis, and two had suprapubic wound hematomas. Using the laparoscopic approach the hospital stay decreased from 4.1 to 1.27 days (69%) (P < 0.001) and return to work decreased from 28.4 to 14.8 days (49%) (P < 0.01). Live donation increased by 67 per cent. We conclude that the laparoscopic procurement of kidneys for transplantation compares well with the open method. It offers several advantages that may increase the living donor pool. |
| doi_str_mv | 10.1177/000313480106700408 |
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Twenty-nine patients (Group I) had open kidney procurement, and 30 patients (Group II) had laparoscopic procurement. The mean operative time in Group I was 2:30 hours (range 1:55–2:59), whereas in Group II it was 3:01 hours (1:54–5:21). All kidneys functioned immediately after transplantation. The average warm ischemia time was not calculated in Group I; it was 3.9 minutes (2–15) in Group II. Intraoperative complications occurred in two patients in Group II. One patient had bleeding from an accessory renal artery. The second patient had a tear in the splenic capsule. No ureteral complications occurred in either group. Postoperatively one patient in Group I developed incisional hernia, one developed pneumothorax, and two developed atelectasis. In Group II one patient developed pancreatitis, one developed flank ecchymosis, and two had suprapubic wound hematomas. Using the laparoscopic approach the hospital stay decreased from 4.1 to 1.27 days (69%) (P < 0.001) and return to work decreased from 28.4 to 14.8 days (49%) (P < 0.01). Live donation increased by 67 per cent. We conclude that the laparoscopic procurement of kidneys for transplantation compares well with the open method. It offers several advantages that may increase the living donor pool.</description><identifier>ISSN: 0003-1348</identifier><identifier>EISSN: 1555-9823</identifier><identifier>DOI: 10.1177/000313480106700408</identifier><identifier>PMID: 11308000</identifier><identifier>CODEN: AMSUAW</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Absenteeism ; Academic Medical Centers ; Adolescent ; Adult ; Aged ; Biological and medical sciences ; Blood & organ donations ; Female ; Hospitals, University ; Humans ; Kidney Transplantation - methods ; Kidneys ; Laparoscopy - adverse effects ; Laparoscopy - methods ; Length of Stay - statistics & numerical data ; Living Donors ; Male ; Medical procedures ; Medical sciences ; Michigan ; Middle Aged ; Nephrectomy - adverse effects ; Nephrectomy - methods ; Surgery (general aspects). Transplantations, organ and tissue grafts. 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Twenty-nine patients (Group I) had open kidney procurement, and 30 patients (Group II) had laparoscopic procurement. The mean operative time in Group I was 2:30 hours (range 1:55–2:59), whereas in Group II it was 3:01 hours (1:54–5:21). All kidneys functioned immediately after transplantation. The average warm ischemia time was not calculated in Group I; it was 3.9 minutes (2–15) in Group II. Intraoperative complications occurred in two patients in Group II. One patient had bleeding from an accessory renal artery. The second patient had a tear in the splenic capsule. No ureteral complications occurred in either group. Postoperatively one patient in Group I developed incisional hernia, one developed pneumothorax, and two developed atelectasis. In Group II one patient developed pancreatitis, one developed flank ecchymosis, and two had suprapubic wound hematomas. Using the laparoscopic approach the hospital stay decreased from 4.1 to 1.27 days (69%) (P < 0.001) and return to work decreased from 28.4 to 14.8 days (49%) (P < 0.01). Live donation increased by 67 per cent. We conclude that the laparoscopic procurement of kidneys for transplantation compares well with the open method. It offers several advantages that may increase the living donor pool.</description><subject>Absenteeism</subject><subject>Academic Medical Centers</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Blood & organ donations</subject><subject>Female</subject><subject>Hospitals, University</subject><subject>Humans</subject><subject>Kidney Transplantation - methods</subject><subject>Kidneys</subject><subject>Laparoscopy - adverse effects</subject><subject>Laparoscopy - methods</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Living Donors</subject><subject>Male</subject><subject>Medical procedures</subject><subject>Medical sciences</subject><subject>Michigan</subject><subject>Middle Aged</subject><subject>Nephrectomy - adverse effects</subject><subject>Nephrectomy - methods</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. 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Using the laparoscopic approach the hospital stay decreased from 4.1 to 1.27 days (69%) (P < 0.001) and return to work decreased from 28.4 to 14.8 days (49%) (P < 0.01). Live donation increased by 67 per cent. We conclude that the laparoscopic procurement of kidneys for transplantation compares well with the open method. It offers several advantages that may increase the living donor pool.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>11308000</pmid><doi>10.1177/000313480106700408</doi><tpages>4</tpages></addata></record> |
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| subjects | Absenteeism Academic Medical Centers Adolescent Adult Aged Biological and medical sciences Blood & organ donations Female Hospitals, University Humans Kidney Transplantation - methods Kidneys Laparoscopy - adverse effects Laparoscopy - methods Length of Stay - statistics & numerical data Living Donors Male Medical procedures Medical sciences Michigan Middle Aged Nephrectomy - adverse effects Nephrectomy - methods Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the urinary system Time Factors Tissue and Organ Procurement - methods Transplants & implants Treatment Outcome |
| title | Laparoscopic versus Conventional Live Donor Nephrectomy: Experience in a Community Transplant Program |
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