Hand-Assisted Laparoscopic Nephrectomy for Polycystic Kidney Disease
| Autor: | Michael R. Marvin, Christopher M. Jones, Robert M. Cannon, Mary Eng |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty Incisional hernia medicine.medical_treatment Population Autosomal dominant polycystic kidney disease Nephrectomy Polycystic kidney disease medicine Scientific Papers Hand-Assisted Laparoscopy Humans education Retrospective Studies education.field_of_study Polycystic Kidney Diseases business.industry Length of Stay Middle Aged medicine.disease Surgery Transplantation Treatment Outcome Female Complication business Learning Curve Bilateral Nephrectomy |
| Zdroj: | JSLS : Journal of the Society of Laparoendoscopic Surgeons |
| ISSN: | 1938-3797 1086-8089 |
| Popis: | Hand-assisted laparoscopic nephrectomy for polycystic kidney disease seemed to result in shorter length of hospital stay and reduced need for transfusion compared with patients undergoing the same procedure with an open technique. Background and Objectives: Historically, nephrectomy for autosomal dominant polycystic kidney disease was performed by an open technique. We performed this study to compare outcomes in hand-assisted laparoscopic nephrectomy with open nephrectomy in this population. Methods: Charts of patients with autosomal dominant polycystic kidney disease who underwent nephrectomy by a transplant surgeon from January 1, 2000, to December 31, 2011, were reviewed. The hand-assisted laparoscopic nephrectomy group was compared with the open group. Data collected included unilateral versus bilateral nephrectomy, operative time, complications, transfusion requirement, and length of stay. Results: Of the 78 patients identified, 18 underwent open transabdominal nephrectomy, 56 underwent hand-assisted laparoscopic nephrectomy, and 2 underwent hand-assisted laparoscopic nephrectomy that was converted to an open procedure. Two patients were excluded because another major procedure was performed at the same time as the nephrectomy. Operative times were similar. Patients undergoing open bilateral nephrectomy were more likely to receive transfusion (odds ratio, 3.57 [95% confidence interval, 0.74–17.19]; P = .016), and the length of stay was longer in the open groups (5.9 days vs 4.0 days for unilateral [P = .013] and 7.8 days vs 4.6 days for bilateral [P = .001]). Overall complication rates were similar. The most frequent complications associated with hand-assisted laparoscopic nephrectomy were the development of an incisional hernia at the hand-port site and arteriovenous fistula thrombosis. Conclusion: Hand-assisted laparoscopic nephrectomy can be safely performed without increased operative times or complications. The hand-assisted laparoscopic nephrectomy group enjoyed a shorter length of stay, and fewer patients in this group received transfusion. For patients considering renal transplantation, avoidance of transfusion is important to prevent sensitization and limiting access to compatible organs. |
| Databáze: | OpenAIRE |
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