scholarly journals IS RIGHT DONOR NEPHRECTOMY SAFE? OUR EXPERIENCE IN ARMED FORCES INSTITUTE OF UROLOGY

2021 ◽  
Vol 71 (2) ◽  
pp. 409-13
Author(s):  
Haroon Sabir Khan ◽  
Arshad Mahmood ◽  
Ahsin Manzoor Bhatti ◽  
Sohail Sabir ◽  
Sarwar Alvi ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Armed Forces ◽  
Warm Ischemia ◽  
Donor Nephrectomy ◽  
Warm Ischemia Time ◽  
Ischemia Time ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Related Donor ◽  
The Mean

Objective: To identify any adversities in the intraoperative and early postoperative outcome of right live-related donor nephrectomy. Study Design: Cross sectional study. Place and Duration of Study: Armed Forces Institute of Urology, Rawalpindi, from Jan 2013 to Jul 2015. Methodology: A total of 143 successive patients underwent open live donor nephrectomies (right=41). Perioperative outcome for both sided procedures were analyzed to identify any difference as regard the intraoperative (warm ischemia time, total duration of surgery, peroperative complications) and early postoperative parameters (days of hospitalization, complications). Results: No statistically significant difference was found in studied parameters like total operative time, the warm ischemia time, duration of hospital stay and the intra- and early postoperative complications amongst both the groups. The mean warm ischemia time was 86 ± 12 seconds (Rt) versus 90 ± 12 seconds (Lt). The mean time for surgery was 110 ± 18.1 minutes (Rt) versus 121 ± 18.2 minutes (Lt). There were only five minor complications and one major complication. Conclusion: Right live-related donor nephrectomy is equally safe and feasible option with similar intra-and postoperative complications as for left side. Therefore, whenever required, it is safe to leave the donor with a better functioning kidney.

scholarly journals Comparison of Transperitoneal and Retroperitoneal Laparoendoscopic Single-site Donor Nephrectomy

2020 ◽  
Author(s):  
Chung-Yu Lin ◽  
Ching-Chia Li ◽  
Hung-Lung Ke ◽  
Wen-Jeng Wu ◽  
Yii-Her Chou ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Operation Time ◽  
Warm Ischemia ◽  
Donor Nephrectomy ◽  
Warm Ischemia Time ◽  
Single Site ◽  
Perioperative Outcomes ◽  
Ischemia Time ◽  
Laparoendoscopic Single Site

Abstract Background: Laparoscopic living-donor nephrectomy is the standard technique at high-volume renal transplant centers. Laparoendoscopic single-site donor nephrectomy (LESS-DN) is a relatively novel minimally invasive surgery, which was differed to transperitoneal and retroperitoneal approaches. We present a retrospective analysis of our single-institution donor nephrectomy series comparing the transperitoneal to retroperitoneal LESS-DN with regards to operative outcomes.Materials and Methods: Ten patients who underwent LESS-DN from 2017–2019 were enrolled at our center. The same surgeon performed all cases. The two approaches were compared retrospectively and evaluated for differences in perioperative outcomes, including operation time, console time, blood loss, graft warm ischemia time, postoperative pain, length of stay (LOS), wound size, postoperative pain, and renal function post LESS-DN at less than one year.Results: Total operating time (315 ± 82.69 vs. 191 ± 24.9 min, p = 0.016), console time (224 ± 74.15 vs. 110 ± 19.84 min, p = 0.016), and LOS (8.4 ± 1.82 vs. 4.8 ± 1.10 days, p = 0.013) were significantly longer in the transperitoneal group. The wound size (44 ± 3.81 vs. 68.2 ± 13.5 mm, p = 0.038) was significantly smaller in the transperitoneal group. There was no significant difference in other parameters, including blood loss, warm ischemia time, and postoperative pain from day one to day three.Conclusions: Retroperitoneal LESS-DN results in similar perioperative outcomes as transperitoneal LESS-DN without compromising donor safety, and while providing a faster operation time, console time, shorter LOS, and a trend toward a shorter warm ischemia time.

Warm ischemia time does not correlate with recipient graft function in laparoscopic donor nephrectomy

2003 ◽  
Vol 17 (5) ◽  
pp. 746-749 ◽  
Author(s):  
M. M. Buzdon ◽  
E. Cho ◽  
S. C. Jacobs ◽  
B. Jarrell ◽  
J. L. Flowers
Keyword(s):  
Graft Function ◽  
Warm Ischemia ◽  
Donor Nephrectomy ◽  
Warm Ischemia Time ◽  
Laparoscopic Donor Nephrectomy ◽  
Ischemia Time

Comparison of Outcomes of Open versus Laparoscopic Living Donor Nephrectomy in Nepal

2020 ◽  
Vol 42 (1) ◽  
pp. 31-35
Author(s):  
Prem R Sigdel ◽  
Diwas Gnyawali ◽  
Bipendra DK Rai ◽  
Pawan Dhital ◽  
Purushottam Parajuli ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Demographic Data ◽  
Graft Function ◽  
Length Of Hospital Stay ◽  
Warm Ischemia ◽  
Donor Nephrectomy ◽  
Warm Ischemia Time ◽  
Laparoscopic Donor Nephrectomy ◽  
Ischemia Time ◽  
Living Donor Nephrectomy

Introduction Laparoscopic donor nephrectomy is the gold standard for kidney retrieval in live donors. Until recently, donor nephrectomies were performed only by open technique in Nepal. There is no information on the experience and outcomes of laparoscopic donor nephrectomy in Nepal. The study was done to compare the outcomes among donors undergoing open and laparoscopic nephrectomies, and to compare the graft related outcomes between the two groups receiving these kidneys. MethodsIn this retrospective study, 44 kidney donors from March 2019 to October 2019 were analyzed. Donors were divided into 2 groups: open donor nephrectomy (ODN) and laparoscopic donor nephrectomy (LDN). Parameters for analysis included demographic data, warm ischemia time, surgery time and length of hospital stay. Data on early graft function and complications in recipients till 30th post-operative day were compared. ResultsThere were 22 donors each in the ODN and LDN groups. Baseline characteristics of the donors were comparable between two groups. Mean surgery duration (183.55±43.31 minutes vs 117.73±18.75 minutes) and first warm ischemia time (11.22±4.34 minutes vs 2.3±0.8 minutes) was significantly high in LDN. Hemoglobin drop, post-operative complications in donors, creatinine of donors at discharge, mean hospital stay, graft function at one month and complications in recipients were comparable among ODN and LDN. Pain score in 1st post-operative day was comparable between two groups, however, pain was significantly less in second post-operative day in LDN. ConclusionLaparoscopic donor nephrectomy is feasible in Nepal and associated with acceptable morbidity and graft function when compared to ODN.

scholarly journals Comparison of Distal Hypospadias Repair in Circumcised Patients and Uncircumcised Patients

ISRN Urology ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Fahimeh Kazemi Rashed ◽  
Rasool Gholizade
Keyword(s):  
Postoperative Complications ◽  
Functional Results ◽  
Hypospadias Repair ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
History Of ◽  
The Mean ◽  
Distal Hypospadias ◽  
One Year ◽  
Results Of Surgery

Hypospadias is the most common anomaly in the male genital tract with an incidence of 0.8–8.2 per 1000 live male births. Routinely, hypospadias cases are repaired after one year of age, and it is recommended that a child with hypospadias not to be circumcised until hypospadias repair is completed. This study was conducted to determine whether or not circumcision prior to hypospadias repair increases the risk of complications. 30 circumcised patients and 30 persons without a history of circumcision and hypospadias were enrolled in this study and underwent surgery for hypospadias repair. The results of surgery compared between two groups. In the uncircumcised group, the mean durations of surgery and hospitalization were  min and days. In circumcised group, the mean duration of surgery and hospitalization were minutes and days. There was no significant difference between these criteria and other complications of the two groups. This study shows that postoperative complications in circumcised distal hypospadias patients do not increase. Cosmetic and functional results were excellent. If there are failures in therapy and in case of postoperative complications, it is better to notice other factors such as infection.

80 Laparoscopic living donor nephrectomy: Predictors of warm ischemia time and consequences for the transplant

2016 ◽  
Vol 15 (3) ◽  
pp. e80-e80a
Author(s):  
T. Benoit ◽  
M. Roumiguie ◽  
J.B. Beauval ◽  
N. Doumerc ◽  
F. Sallusto ◽  
...  
Keyword(s):  
Living Donor ◽  
Warm Ischemia ◽  
Donor Nephrectomy ◽  
Warm Ischemia Time ◽  
Ischemia Time ◽  
Living Donor Nephrectomy

scholarly journals Preoperative scoring systems used in retroperitoneoscopic partial nephrectomy for T1-T2 renal tumors

2017 ◽  
Vol 12 (3) ◽  
pp. 141-147
Author(s):  
M.V. PIRVUT ◽  
◽  
N. GRIGORE ◽  
I. MIHAI ◽  
A. BENCHERKI ◽  
...  
Keyword(s):  
Blood Loss ◽  
Partial Nephrectomy ◽  
Operative Time ◽  
Warm Ischemia ◽  
Warm Ischemia Time ◽  
P Value ◽  
Ischemia Time ◽  
Contralateral Kidney ◽  
Risk Patients ◽  
The Mean

Introduction. P.A.D.U.A. (The preoperative aspects and dimensions used for anatomic), R.E.N.A.L. (radius exophytic/endophytic nearness anterior/posterior location) and zonal NePhRO scoring were developed in an effort to predict the intraoperative (warm time ischemia, blood loss) and postoperative complications in patients undergoing partial nephrectomy, with an important role on surgical decision-making (2-4). Materials and methods. Between January 2014 and July 2017, 37 patients(p) underwent retroperitoneoscopic nephro-sparing surgery at our center for clinically localized renal tumor. All patients had a normal contralateral kidney. The selection of patients for nephro-sparing surgery was based on preoperative CT scan, location of the tumor, the individual general health status of the patient and individual surgeon preferences. A chart review was carried out, including age, sex, anatomic preoperative scoring system (P.A.D.U.A., R.E.N.A.L. nephrometry and zonal NePhRO), operative time (skin opening to skin closing), estimated blood loss (EBL), warm ischemia time (WIT), hospital stay. Results. The mean age of patients with partial nephrectomy was 54.3±9.1 years. Mean preoperative serum creatinine level for the patient group was 0.97±0.14 mg/dl. All patients had normal contralateral kidney. Average tumor diameter in this group was 3.6± 0.86 cm. When using P.A.D.U.A. score to predict warm time ischemia p value was of 0.001, even if the mean warm ischemia time is higher in medium risk patients than in high risk patients 24.3 min vs. 23.2 min. R.E.N.A.L. nephrometry score was able to predict the warm ischemia time according to the risk groups (17.6 vs. 23.9 vs. 31 min) with a p value under 0.001. Zonal NePhRO score was statistically correlated with total operative time, blood loss, warm ischemia and renal function decrease, all with a p value < 0.05. Conclusion. P.A.D.U.A. score, R.E.N.A.L. nephrometry score and Zonal NePhRO score have proved to be reliable preoperative tools in order to evaluate surgical complexity and to predict outcomes such as warm time ischemia, blood loss, postoperative estimated GFR and complications rate.

PNEUMOSLEEVE-ASSISTED LAPAROSCOPY REDUCES WARM ISCHEMIA TIME FOR LIVE-DONOR NEPHRECTOMY IN THE PORCINE MODEL

1999 ◽  
pp. 23
Author(s):  
Douglas A. West ◽  
Robert G. Moore ◽  
George A. Vogler ◽  
Raul O. Parra ◽  
Chintalapati Varma ◽  
...  
Keyword(s):  
Porcine Model ◽  
Warm Ischemia ◽  
Donor Nephrectomy ◽  
Warm Ischemia Time ◽  
Live Donor ◽  
Ischemia Time ◽  
Live Donor Nephrectomy

scholarly journals Knotless retroperitoneoscopic nephron-sparing surgery for small renal masses: Comparison of bipolar sutureless technique and barbed suture technique

2018 ◽  
Vol 46 (4) ◽  
pp. 1649-1656 ◽  
Author(s):  
Jianfei Ye ◽  
Shudong Zhang ◽  
Xiaojun Tian ◽  
Guoliang Wang ◽  
Lei Zhao ◽  
...  
Keyword(s):  
Operative Time ◽  
Suture Technique ◽  
Warm Ischemia ◽  
Warm Ischemia Time ◽  
Nephron Sparing Surgery ◽  
Barbed Suture ◽  
Ischemia Time ◽  
Sutureless Technique ◽  
Nephron Sparing ◽  
The Mean

Objective Laparoscopic knot-tying and suturing are the most difficult steps in shortening the warm ischemia time and learning curve of laparoscopic nephron-sparing surgery. This study was performed to demonstrate the safety, oncological efficacy, and technical tips of sutureless retroperitoneal laparoscopic nephron-sparing surgery (RPNSS). Methods This retrospective study included 78 cases of RPNSS using a sutureless technique and 126 cases of RPNSS using a single-layer barbed self-retaining suture technique performed from December 2012 to December 2016. Results The mean warm ischemia time was significantly shorter in the sutureless technique group than in the barbed self-retaining suture technique group (6.8 vs. 21.1 minutes, respectively). There was no significant difference in the mean age, body mass index, R.E.N.A.L. Nephrometry score, operative time, maximal tumor diameter, intraparenchymal depth, blood loss, operative time, transfusion rate, complication rate, or postoperative hospital stay between the two groups. No open conversion was needed. No positive margins or local recurrence were observed during follow-up. Conclusions The sutureless technique was proven to be safe and oncologically effective and may allow novice laparoscopic surgeons to easily and quickly master RPNSS, a technically difficult procedure.

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