Laparoscopic Nephrectomy for Massive Kidneys in Polycystic Kidney Disease
| Autor: | A. Collini, Giuliana Ruggieri, Roberto Benigni, Mario Carmellini |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Bilateral nephrectomy
Adult Male medicine.medical_specialty medicine.medical_treatment Operative Time Autosomal dominant polycystic kidney disease Kidney weight Nephrectomy Autosomal dominant polycystic Kidney disease (ADPKD) Postoperative Complications medicine Polycystic kidney disease Polycystic Kidney Humans Laparoscopy Aged Retrospective Studies medicine.diagnostic_test business.industry Laparoscopic nephrectomy Postoperative complication Length of Stay Middle Aged Polycystic kidneys Polycystic Kidney Autosomal Dominant medicine.disease Surgery Hand-assisted laparoscopic nephrectomy Female Treatment Outcome Autosomal Dominant Methodologies Article business Bilateral Nephrectomy |
| Zdroj: | JSLS : Journal of the Society of Laparoscopic & Robotic Surgeons |
| ISSN: | 1938-3797 1086-8089 |
| DOI: | 10.4293/jsls.2020.00107 |
| Popis: | Background and Objectives: Laparoscopic nephrectomy is now considered a feasible surgical approach, even for large kidneys. In the case of massive kidneys, laparoscopy can be problematic, so that some authors suggest an open approach. However, previous studies have shown that hand-assisted laparoscopic nephrectomy (HALN) may represent a useful compromise. We describe our hand-assisted laparoscopic technique for nephrectomy of large kidneys (> 2500 g) to encourage the use of laparoscopy for nephrectomy in autosomal dominant polycystic kidney disease. Methods: We retrospectively analyzed data from 26 nephrectomies in 17 patients who underwent HALN for ADPKD and compared them to a group of 22 nephrectomies in 18 patients with open surgical technique. Results: The duration of the procedure was significantly longer in the laparoscopic group, with a median of 180 minutes versus 90 minutes for the unilateral nephrectomies, and 240 minutes versus 122 minutes for the bilateral procedures. The median kidney weight in the open group was 2500 g (range 1300 – 4500 g), while the median weight in the HALN group was 2375 g (range 1000 – 4700 g). The median hospital stay was comparable. No significant differences were recorded in the intra- and postoperative complication rate. Conclusion: Hand-assisted laparoscopic nephrectomy can be considered a technique of choice for patients suffering from ADPKD requiring nephrectomy, also with massive kidneys weighing more than 3500 g. Compared to open nephrectomy, HALN can be performed safely, with reasonably longer operating times and without major complications, and offers a significant reduction in hospitalization time, pain and postoperative discomfort. |
| Databáze: | OpenAIRE |
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