RESUMO
Aim: The open simple nephrectomy is associated with significant mobidity and laparoscopic nephrectomy is now becoming the standared of care in many centers. In this study we will try to evaluate the actual results of laparoscpic nephrectomy for benign renal lesions in comparison to open nephrectomy
Methods: 17 patients were divided into 2 groups in a non-randomized trial. 8 patients 5 males and 3 females, aged 19-56 underwent open simple nephrectomy. 9 patients, 3 males and 6 females, aged 16-53, underwent laparoscopic simple nephrectomy [3 retroperitoneal and 6 transperitoneal]
Results: In spite of the high conversion rate [4 out of 9 cases] the laparoscopic simple nephrectomy was superior to the open technique in terms of intraoperative complications [0 versus 2 patients who needed blood transfusion and another with pleural injury], duration of analgesia requirements [2 versus 4.5 days post operative], starting oral feeding [1 versus 3 days post operative], wound infection [0 versus 2 cases], hospital stay [3 versus 7.5 days] and time for full recovery [22 versus 40 days] The superiority of the laparoscopic simple nephrectomy in terms of analgesia requirement, post operative oral feeding, hospital stay and time for complete recovery were all statistically significant
Conclusion: In spite of this being a preliminary experience of the Urology Department started in association with the General Surgery Department in TBRI, laparoscopic simple nephrectomy was not only found to be a safe procedure but also other all parameters were in favor of the laparoscopic versus the open simple nephrectomy. The conversion rate was expectedly high but it is not until the learning curve peaks up before the true rate appear and properly judged
RESUMO
Four groups were enrolled in this study: Group I included 30 infants and children with isolated Down syndrome [DS], group II included 15 infants and children with DS and congenital heart disease [CHD], group III included 20 infants and children with different types of CHD and group IV comprised 15 clinically healthy infants and children. Full medical history taking, thorough clinical examination, CBC, assessment of RBCs indices, reticulocytic count, serum folate, serum vitamin B12, serum iron [SI], total iron binding capacity [TIBC], serum ferritin and transferrin% saturation calculation were done for all studied infants and children. Cardiac evaluation using X-ray chest and heart, ECG and echocardiography was done for patients in groups II and III. The current study confirmed the presence of significantly high prevalence of macrocytosis in children with DS with and without CHD, which is not associated with a deficiency of serum folate and/or vitamin B12, an observation that necessitates putting norms of RBCs indices for this special category of patients. Also, the study showed the inverse correlation between RBCs indices and markers of iron status in patients with isolated IDS, DS and CHD and isolated CHD that needs to be considered when investigating whether a child belonging to these groups is anemic and the cause of the anemia