Experience with 750 consecutive laparoscopic donor nephrectomies--is it time to use a standardized classification of complications?
| Autor: | A. Breda, P.G. Schulam, Jonathan D. Harper, J.L. Veale, John T. Leppert, Hans Albin Gritsch |
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| Rok vydání: | 2009 |
| Předmět: |
Nephrology
Adult Male Reoperation medicine.medical_specialty Adolescent Urology medicine.medical_treatment Nephrectomy Postoperative Complications Internal medicine medicine Living Donors Humans Registries Laparoscopy Kidney transplantation Aged medicine.diagnostic_test business.industry Cosmesis Length of Stay Middle Aged medicine.disease Kidney Transplantation Surgery Endoscopy Transplantation Female Complication business |
| Zdroj: | The Journal of urology. 183(5) |
| ISSN: | 1527-3792 |
| Popis: | Laparoscopic living donor nephrectomy offers patients the benefits of decreased morbidity and improved cosmesis, while maintaining equivalent graft outcomes and complication rates similar to those of open donor surgery. With expressed concern for donor safety, using a standardized complication scale would allow combining data in a donor registry so potential donors could be adequately followed and counseled. We present the largest series to our knowledge of laparoscopic living donor nephrectomy by a single surgeon.The institution's initial 750 laparoscopic living donor nephrectomies were included in the study, and a retrospective and prospective chart and database analysis was performed.Mean donor age was 40.5 years and average body mass index was 25.7 kg/m(2). There were 175 patients (23%) with 2 or more renal arteries while 161 (21.5%) had early arterial bifurcations. There were 3 open conversions (0.4%) and the overall complication rate was 5.46%. Median hospital stay was 1 day and the readmission rate was 1.2%. There were 5 reoperations (0.67%), none of which was for the control of bleeding. No patients required a blood transfusion and there were no mortalities. Using a modified Clavien classification of complications for living donor nephrectomy 65.8% were grade 1, 31.7% grade 2 (12.2% grade 2a, 14.6% grade 2b, 4.9% grade 2c) and 2.4% grade 3. There were no grade 4 complications.With appropriate patient selection and operative experience, laparoscopic living donor nephrectomy is a safe procedure associated with low morbidity. The use of a standardized complication system specific for this procedure is encouraged and could aid in counseling potential donors in the future. |
| Databáze: | OpenAIRE |
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