Subcostal mini incision: a good option for donor nephrectomy
AUTOR(ES)
Kanashiro, Hideki, Falci Jr, Renato, Piovisan, Affonso Celso, Saito, Fernando, Torricelli, Fabio Cesar Miranda, Nahas, Willian Carlos
FONTE
Clinics
DATA DE PUBLICAÇÃO
2010
RESUMO
OBJECTIVES: We describe the results of over one hundred nephrectomies performed using a subcostal mini incision. INTRODUCTION: A major effort has been undertaken to encourage living donor renal transplantation. New techniques that use minimally invasive approaches to perform donor nephrectomy have been progressively accepted. Among these new procedures is the mini-incision approach. METHODS: We prospectively analyzed one hundred and seventeen consecutive donors that were subjected to subcostal mini-incision nephrectomy at a single center. Surgical time, warm and cold ischemia time, intraoperative complications, time until hospital discharge, presence of infection, bleeding, the need for a second operation, and death were analyzed. Eventual loss of donor renal function was indicated by increases in serum creatinine and proteinuria. RESULTS: The mean time of surgery was 180.5 ± 26.2 minutes. The mean warm ischemia time was 93 ±8.3 seconds, while the mean cold ischemia time was 85.9 (±23.5) minutes. We had one case with an intraoperative complication, and only two patients required another operation. An intra-abdominal abscess occurred in one patient (0.85%), proteinuria occurred in one patient (0.85%), and a transitory increase of creatinine levels occurred in two patients (1.7%). DISCUSSION: Reducing the length of the abdominal incision did not influence surgical time or result in an increase in intraoperative complications relative to our historical data or literature reports. Organ preparation was accomplished successfully with a brief warm ischemia time. Additionally, the mean hospital stay was short, and few surgical complications occurred. CONCLUSION: The use of a subcostal mini incision is both safe and similar to conventional techniques previously described in the literature.
Documentos Relacionados
- Laparoscopic nephrectomy through a pfannenstiel incision
- Giant Nasolabial Cyst Treated Using Neumann Incision: Case Report
- Influence of pneumoperitoneum on tumor implantation in parietal incision: a comparative study of trocar incision and laparotomy in rats
- Comparison of laparoendoscopic single-site donor nephrectomy and conventional laparoscopic donor nephrectomy: donor and recipient outcomes
- A cost-effective technique for pure laparoscopic live donor nephrectomy