A comparison of hand-assisted and pure laparoscopic techniques in live donor nephrectomy
PURPOSE: To compare hand-assisted laparoscopic donor nephrectomy and pure laparoscopic live donor nephrectomy techniques in live donor nephrectomy. METHODS: In this retrospective study, we included all patients submitted to hand-assisted laparoscopic donor nephrectomy and pure laparoscopic live dono...
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| Format: | Article |
| Language: | English |
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Elsevier España
2008-01-01
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| Series: | Clinics |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322008000600015 |
| _version_ | 1818237307300347904 |
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| author | Anibal Wood Branco William Kondo Alcides José Branco Filho Marco Aurélio de George Marlon Rangel Luciano Carneiro Stunitz |
| author_facet | Anibal Wood Branco William Kondo Alcides José Branco Filho Marco Aurélio de George Marlon Rangel Luciano Carneiro Stunitz |
| author_sort | Anibal Wood Branco |
| collection | DOAJ |
| description | PURPOSE: To compare hand-assisted laparoscopic donor nephrectomy and pure laparoscopic live donor nephrectomy techniques in live donor nephrectomy. METHODS: In this retrospective study, we included all patients submitted to hand-assisted laparoscopic donor nephrectomy and pure laparoscopic live donor nephrectomy between May 2002 and December 2007. The operative data and post-operative courses were reviewed. Information was collected on the operative time, warm ischemia time, estimated blood loss, intra-operative complications, time to first oral intake, length of hospital stay, and post-operative complications. The data were analyzed using Student's t -tests and Fisher exact tests as appropriate, with statistical significance defined as p < 0.05. RESULTS: The means of the operative duration, warm ischemia time and intra-operative bleeding were 83 min, 3.6 min and 130.9 cc, respectively, for hand-assisted laparoscopic donor nephrectomy, and 78.4 min, 2.5 min and 98.9 cc, respectively, for pure laparoscopic live donor nephrectomy (p=0.29, p<0.0001 and p=0.08, respectively). Intra-operative complications occurred in 6% of patients submitted to hand-assisted laparoscopic donor nephrectomy and in 4.5% of those submitted to pure laparoscopic live donor nephrectomy (p=0.68). Only one patient from each group required conversion to open surgery; one person receiving hand-assisted laparoscopic donor nephrectomy had bleeding and one person receiving pure laparoscopic live donor nephrectomy had low carbon dioxide levels during the warm ischemia period. Compared with patients receiving hand-assisted laparoscopic donor nephrectomy, patients submitted to pure laparoscopic live donor nephrectomy were able to take their first meal earlier (12.5 vs. 9.2 hours, p=0.046), were discharged home sooner (2.8 vs. 1.4 days, p<0.0001) and had fewer post-operative complications (7.5% vs. 0.6%, p=0.04). CONCLUSIONS: Pure laparoscopic live donor nephrectomy had some advantages over hand-assisted laparoscopic donor nephrectomy in terms of the warm ischemia time, time to first oral intake, length of hospital stay, and post-operative donor complications. |
| first_indexed | 2024-12-12T12:23:41Z |
| format | Article |
| id | doaj.art-399f44c44a4f47f5a8cbe459e6df5886 |
| institution | Directory Open Access Journal |
| issn | 1807-5932 1980-5322 |
| language | English |
| last_indexed | 2024-12-12T12:23:41Z |
| publishDate | 2008-01-01 |
| publisher | Elsevier España |
| record_format | Article |
| series | Clinics |
| spelling | doaj.art-399f44c44a4f47f5a8cbe459e6df58862022-12-22T00:24:35ZengElsevier EspañaClinics1807-59321980-53222008-01-0163679580010.1590/S1807-59322008000600015A comparison of hand-assisted and pure laparoscopic techniques in live donor nephrectomyAnibal Wood BrancoWilliam KondoAlcides José Branco FilhoMarco Aurélio de GeorgeMarlon RangelLuciano Carneiro StunitzPURPOSE: To compare hand-assisted laparoscopic donor nephrectomy and pure laparoscopic live donor nephrectomy techniques in live donor nephrectomy. METHODS: In this retrospective study, we included all patients submitted to hand-assisted laparoscopic donor nephrectomy and pure laparoscopic live donor nephrectomy between May 2002 and December 2007. The operative data and post-operative courses were reviewed. Information was collected on the operative time, warm ischemia time, estimated blood loss, intra-operative complications, time to first oral intake, length of hospital stay, and post-operative complications. The data were analyzed using Student's t -tests and Fisher exact tests as appropriate, with statistical significance defined as p < 0.05. RESULTS: The means of the operative duration, warm ischemia time and intra-operative bleeding were 83 min, 3.6 min and 130.9 cc, respectively, for hand-assisted laparoscopic donor nephrectomy, and 78.4 min, 2.5 min and 98.9 cc, respectively, for pure laparoscopic live donor nephrectomy (p=0.29, p<0.0001 and p=0.08, respectively). Intra-operative complications occurred in 6% of patients submitted to hand-assisted laparoscopic donor nephrectomy and in 4.5% of those submitted to pure laparoscopic live donor nephrectomy (p=0.68). Only one patient from each group required conversion to open surgery; one person receiving hand-assisted laparoscopic donor nephrectomy had bleeding and one person receiving pure laparoscopic live donor nephrectomy had low carbon dioxide levels during the warm ischemia period. Compared with patients receiving hand-assisted laparoscopic donor nephrectomy, patients submitted to pure laparoscopic live donor nephrectomy were able to take their first meal earlier (12.5 vs. 9.2 hours, p=0.046), were discharged home sooner (2.8 vs. 1.4 days, p<0.0001) and had fewer post-operative complications (7.5% vs. 0.6%, p=0.04). CONCLUSIONS: Pure laparoscopic live donor nephrectomy had some advantages over hand-assisted laparoscopic donor nephrectomy in terms of the warm ischemia time, time to first oral intake, length of hospital stay, and post-operative donor complications.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322008000600015LaparoscopyNephrectomyKidney transplantationLiving donorHand-assisted |
| spellingShingle | Anibal Wood Branco William Kondo Alcides José Branco Filho Marco Aurélio de George Marlon Rangel Luciano Carneiro Stunitz A comparison of hand-assisted and pure laparoscopic techniques in live donor nephrectomy Clinics Laparoscopy Nephrectomy Kidney transplantation Living donor Hand-assisted |
| title | A comparison of hand-assisted and pure laparoscopic techniques in live donor nephrectomy |
| title_full | A comparison of hand-assisted and pure laparoscopic techniques in live donor nephrectomy |
| title_fullStr | A comparison of hand-assisted and pure laparoscopic techniques in live donor nephrectomy |
| title_full_unstemmed | A comparison of hand-assisted and pure laparoscopic techniques in live donor nephrectomy |
| title_short | A comparison of hand-assisted and pure laparoscopic techniques in live donor nephrectomy |
| title_sort | comparison of hand assisted and pure laparoscopic techniques in live donor nephrectomy |
| topic | Laparoscopy Nephrectomy Kidney transplantation Living donor Hand-assisted |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322008000600015 |
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