ABSTRACT
PURPOSE: Laparoscopic live donor nephrectomy has acquired an important role in the era of minimally invasive surgery. Laparoscopic harvesting of the right kidney is technically more challenging than that of the left kidney because of the short right renal vein and the need to retract the liver away from the right kidney. The aim of this article is to report our experience with right laparoscopic live donor nephrectomies. MATERIALS AND METHODS: We performed a retrospective review of 28 patients who underwent right laparoscopic donor nephrectomies at our service. Operative data and postoperative outcomes were collected, including surgical time, estimated blood loss, warm ischemia time, length of hospital stay, conversion to laparotomy and complications. RESULTS: The procedure was performed successfully in all 28 patients. The mean operative time was 83.8 minutes (range 45 to 180 minutes), with an estimated blood loss of 111.4 mL (range 40 to 350 mL) and warm ischemia time of 3 minutes (range 1.5 to 8 minutes). No donor needed conversion to open surgery and all kidneys showed immediate function after implantation. The average time to initial fluid intake was 12 hours (range 8 to 24 hours). Two cases of postoperative ileus and a case of hematoma on the hand-port site were observed. The mean postoperative hospital stay was 3 days (range 1 to 7 days). CONCLUSIONS: Our data confirm the safety and feasibility of right laparoscopic donor nephrectomy and we believe that the right kidney should not be avoided for laparoscopic donor nephrectomy when indicated.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Kidney/anatomy & histology , Laparoscopy , Living Donors , Nephrectomy/methods , Tissue and Organ Harvesting/methods , Feasibility Studies , Kidney/blood supply , Retrospective StudiesABSTRACT
Laparoscopic donor nephrectomy has become the standard of care at increasing numbers of renal transplant programs worldwide. The majority of laparoscopic living donor kidneys are procured from the left side because of the longer renal vein and improved transplantation. The aim of this article is to report a technique to maximize the right renal vein length by performing a hand-assisted cavotomy.
Subject(s)
Humans , Male , Middle Aged , Laparoscopy , Nephrectomy/methods , Renal Veins , Living Donors , Renal Veins/anatomy & histologyABSTRACT
O objetivo do presente estudo é determinar a prevalência de colesterolose da vesícula biliar em pacientes com colecistite aguda e ou crônica submetidos à colecistectomia e se existe diferença de idade e sexo entre pacientes submetidos à colecistectomia, 100 (10,9 por cento) apresentavam colesterolose da vesícula biliar. Näo houve diferença na idade média entre pacientes sem (46,1 anos) e com colesterolose (42,2 anos). A distribuiçäo por sexo também foi similar entre os 2 grupos. Näo houve diferença na incidência de colecistite aguda entre os pacientes sem (23,3 por cento) e com colesterolose (20 por cento). Dos pacientes com colesterolose, fora identificados cálculos de colesterol em 97 (97 por cento), cálculos de biblirrubinato em 1 (1 por cento) e colecistite aguda acalculosa em 2 (2 por cento) pacientes. Pólipos de colesterol foram observados em 3 pacientes (3 por cento) com colesterolose. Conclui-se que a prevalência de colesterolose da vesícula biliar em pacientes submetidos a colecistectomia por colecistite é elevada e que näo existe diferença de idade e sexo entre pacientes submetidos à colecistectomia com e sem colesterolose