Hand-Assisted Laparoscopic Living-Donor Nephrectomy as an Alternative to Traditional Laparoscopic Living-Donor Nephrectomy
| Autor: | Steven R. Potter, David C. Cronin, J. Wesley Alexander, Kenneth A. Newell, Atsushi Yoshida, Michael J. Hanaway, D. S. Bruce, Joseph F. Buell, Rino Munda, E. Steve Woodle |
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| Rok vydání: | 2002 |
| Předmět: |
medicine.medical_specialty
Time Factors medicine.medical_treatment Posture Hand-Assisted Laparoscopy Nephrectomy Graft function Donor age Living donor nephrectomy Activities of Daily Living Living Donors Humans Immunology and Allergy Medicine Hand assisted Pharmacology (medical) Open donor nephrectomy Ohio Pain Postoperative Transplantation business.industry Length of Stay Kidney Transplantation Surgery Costs and Cost Analysis Operative time Laparoscopy business |
| Zdroj: | American Journal of Transplantation. 2:983-988 |
| ISSN: | 1600-6135 |
| Popis: | The benefits of laparoscopic living-donor nephrectomy (LDN) are well described, while similar data on hand-assisted laparoscopic living-donor nephrectomy (HALDN) are lacking. We compare hand-assisted laparoscopic living-donor nephrectomy with open donor nephrectomy. One hundred consecutive hand-assisted laparoscopic living-donor nephrectomy (10/98-8/01) donor/recipient pairs were compared to 50 open donor nephrectomy pairs (8/97-1/00). Mean donor weights were similar (179.6 +/- 40.8 vs. 167.4 +/- 30.3 lb; p = NS), while donor age was greater among hand-assisted laparoscopic living-donor nephrectomy (38.2 +/- 9.5 vs. 31.2 +/- 7.8 year; p0.01). Right nephrectomies was fewer in hand-assisted laparoscopic living-donor nephrectomy [17/100 (17%) vs. 22/50 (44%); p0.05]. Operative time for hand-assisted laparoscopic living-donor nephrectomy (3.9 +/- 0.7 vs. 2.9 +/- 0.5 h; p0.01) was longer; however, return to diet (6.9 +/- 2.8 vs. 25.6 +/- 6.1 h; p0.01), narcotics requirement (17.9 +/- 6.3 vs. 56.3 +/- 6.4h; p0.01) and length of stay (51.7 +/- 22.2 vs. 129.6 +/- 65.7 h; p0.01) were less than open donor nephrectomy. Costs were similar ($11072 vs. 10840). Graft function and 1-week Cr of 1.4 +/- 0.9 vs. 1.6 +/- 1.1 g/dL (p = NS) were similar. With the introduction of HALDN, our laparoscopic living-donor nephrectomy program has increased by 20%. Thus, similar to traditional laparoscopic donor nephrectomy, hand-assisted laparoscopic living-donor nephrectomy provides advantages over open donor nephrectomy without increasing costs. |
| Databáze: | OpenAIRE |
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