ABSTRACT
@#The aim of this report is to validate the effectiveness and safety of the retroperitoneoscopic donornephrectomy in kidney transplantation and to document the first Retroperitoneoscopic Left DonorNephrectomy in the Philippines done last July 5, 2018.This is a case of 35-year-old female with no comorbidities but with an infraumibilical scar from aprevious cesarean section underwent the first Retroperitoneoscopic Left Donor Nephrectomy in thePhilippines.The principle was pure retroperitoneoscopic donor nephrectomy, hand-assist using Gelport devicewas applied only during vascular transection and allograft retrieval. Access to the retroperitoneumwas established using a modified trocar placement.Retroperitoneal Donor Nephrectomy is a safe and technically-feasible surgery as more urologistsbecome proficient with this approach. The benefits of this approach are in line with the goals of livingkidney allograft retrieval, to minimize morbidity and to maximize safety of the patient. Literatureshows that it has comparable outcomes with Transperitoneal donor nephrectomy (TDN) and opentraditional allograft kidney retrieval.
ABSTRACT
BACKGROUND@#Fournier's gangrene is a serious illness which involves the external genitalia and perineum.It is rare but a life-threatening form of necrotizing fasciitis. Despite aggressive treatment, the mortalityrate is still high. In this study, the authors will discuss the risk factors and mortality of the saiddisease.@*METHODS@#This is a descriptive retrospective study of patients with Fournier's gangrene treated at atertiary government hospital in the Philippines between January 2014 to December 2016.@*RESULTS@#The data from a total of 16 patients (M:F = 15:1) were analyzed. The most number of patientswere in the 5th decade of life (range 17-75 years). The most commonly-associated morbidity wasdiabetes mellitus (50%). Bacterial culture results were obtained in only 15 (93.7%) patients. Of these,13 (86.6%) had polymicrobial bacterial growth while 2 (13.3%) had monomicrobial bacterial growth.Escherichia coli (93.3%) was the most frequent bacterial organism isolated. All the microorganismsisolated showed high resistance to commonly-used antibiotics except for Meropenem, Piperacillin-Tazobactam, and Ceftriaxone. All patients were treated with broad-spectrum antibiotics, and emergentsurgical debridement. The median length of hospital stay (LOS) was 14.3 days and mortality rate was6.25 %.@*CONCLUSION@#Fournier's gangrene is still a grave disease that can be treated by determining the cause ofinfection and prompt surgical treatment is needed to improve patient outcome.