Modified laparoscopic right donor nephrectomy to avoid hilar rotation and decrease warm ischemia time
Background: Right living donor nephrectomy is technically more demanding because of the anatomical differences. Patient safety is the utmost priority because it is performed on healthy donors. We hereby describe our experiences with surgical modifications to minimize donor morbidity and overcome sur...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | Indian Journal of Transplantation |
| Subjects: | |
| Online Access: | http://www.ijtonline.in/article.asp?issn=2212-0017;year=2023;volume=17;issue=4;spage=443;epage=447;aulast=Ranjan |
| _version_ | 1797245470769152000 |
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| author | Satish Kumar Ranjan Pragnesh Desai Vinay Rai Brij Mohan Joshi Ritesh Goel Rohit Kaushal Samit Chaturvedi Ruchir Maheshwari Anant Kumar |
| author_facet | Satish Kumar Ranjan Pragnesh Desai Vinay Rai Brij Mohan Joshi Ritesh Goel Rohit Kaushal Samit Chaturvedi Ruchir Maheshwari Anant Kumar |
| author_sort | Satish Kumar Ranjan |
| collection | DOAJ |
| description | Background: Right living donor nephrectomy is technically more demanding because of the anatomical differences. Patient safety is the utmost priority because it is performed on healthy donors. We hereby describe our experiences with surgical modifications to minimize donor morbidity and overcome surgical challenges in the cases of right living donor nephrectomy. Materials and Methods: In this retrospective comparative study, we analyzed the prospectively maintained perioperative and follow-up data of standard and modified right living donor nephrectomies performed in the recent past 10 years at our institute. We also compared the significant events in corresponding recipients. Student's t-tests were used to define statistical significance. Results: A total of 1530 laparoscopic living donor nephrectomies were performed between 2012 and 2021, of which 117 were on the right side. Of them, 62 donors underwent modified right laparoscopic donor nephrectomy (MRLDN) and 55 underwent standard right laparoscopic donor nephrectomy. The mean duration of surgery (103.44 ± 14.59 vs. 139.45 ± 25.99 min), warm ischemia time (4.30 ± 0.59 vs. 5.89 ± 0.91 min), and blood loss (90.24 ± 24.75 vs. 103.72 ± 33.37 mL) were significantly lower in modified as compared to standard donor nephrectomy (P < 0.05). There was no significant difference in postoperative diuresis, acute tubular necrosis, and serum creatinine at 3 months in the corresponding recipient group. Conclusion: MRLDN is a safe, reliable, and reproducible technique of right laparoscopic donor nephrectomy. |
| first_indexed | 2024-04-24T19:27:25Z |
| format | Article |
| id | doaj.art-31c6cbfdc15548e6a6f1157fc14aac05 |
| institution | Directory Open Access Journal |
| issn | 2212-0017 2212-0025 |
| language | English |
| last_indexed | 2024-04-24T19:27:25Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Transplantation |
| spelling | doaj.art-31c6cbfdc15548e6a6f1157fc14aac052024-03-25T14:41:57ZengWolters Kluwer Medknow PublicationsIndian Journal of Transplantation2212-00172212-00252023-01-0117444344710.4103/ijot.ijot_42_23Modified laparoscopic right donor nephrectomy to avoid hilar rotation and decrease warm ischemia timeSatish Kumar RanjanPragnesh DesaiVinay RaiBrij Mohan JoshiRitesh GoelRohit KaushalSamit ChaturvediRuchir MaheshwariAnant KumarBackground: Right living donor nephrectomy is technically more demanding because of the anatomical differences. Patient safety is the utmost priority because it is performed on healthy donors. We hereby describe our experiences with surgical modifications to minimize donor morbidity and overcome surgical challenges in the cases of right living donor nephrectomy. Materials and Methods: In this retrospective comparative study, we analyzed the prospectively maintained perioperative and follow-up data of standard and modified right living donor nephrectomies performed in the recent past 10 years at our institute. We also compared the significant events in corresponding recipients. Student's t-tests were used to define statistical significance. Results: A total of 1530 laparoscopic living donor nephrectomies were performed between 2012 and 2021, of which 117 were on the right side. Of them, 62 donors underwent modified right laparoscopic donor nephrectomy (MRLDN) and 55 underwent standard right laparoscopic donor nephrectomy. The mean duration of surgery (103.44 ± 14.59 vs. 139.45 ± 25.99 min), warm ischemia time (4.30 ± 0.59 vs. 5.89 ± 0.91 min), and blood loss (90.24 ± 24.75 vs. 103.72 ± 33.37 mL) were significantly lower in modified as compared to standard donor nephrectomy (P < 0.05). There was no significant difference in postoperative diuresis, acute tubular necrosis, and serum creatinine at 3 months in the corresponding recipient group. Conclusion: MRLDN is a safe, reliable, and reproducible technique of right laparoscopic donor nephrectomy.http://www.ijtonline.in/article.asp?issn=2212-0017;year=2023;volume=17;issue=4;spage=443;epage=447;aulast=Ranjanlaparoscopic donor nephrectomynephrectomyright living donor nephrectomy |
| spellingShingle | Satish Kumar Ranjan Pragnesh Desai Vinay Rai Brij Mohan Joshi Ritesh Goel Rohit Kaushal Samit Chaturvedi Ruchir Maheshwari Anant Kumar Modified laparoscopic right donor nephrectomy to avoid hilar rotation and decrease warm ischemia time Indian Journal of Transplantation laparoscopic donor nephrectomy nephrectomy right living donor nephrectomy |
| title | Modified laparoscopic right donor nephrectomy to avoid hilar rotation and decrease warm ischemia time |
| title_full | Modified laparoscopic right donor nephrectomy to avoid hilar rotation and decrease warm ischemia time |
| title_fullStr | Modified laparoscopic right donor nephrectomy to avoid hilar rotation and decrease warm ischemia time |
| title_full_unstemmed | Modified laparoscopic right donor nephrectomy to avoid hilar rotation and decrease warm ischemia time |
| title_short | Modified laparoscopic right donor nephrectomy to avoid hilar rotation and decrease warm ischemia time |
| title_sort | modified laparoscopic right donor nephrectomy to avoid hilar rotation and decrease warm ischemia time |
| topic | laparoscopic donor nephrectomy nephrectomy right living donor nephrectomy |
| url | http://www.ijtonline.in/article.asp?issn=2212-0017;year=2023;volume=17;issue=4;spage=443;epage=447;aulast=Ranjan |
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