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Laparoscopic Vs open donor nephrectomy in live related renal transplantation: Comparison of recipient outcome
34
Indian Journal of Transplantation
Dorsal lumbotomy versus laparoscopy for pretransplant bilateral nephrectomy of small kidneys Muruganandham K, Ruchir Maheshwari, Aneesh Srivastava, Deepak Dubey, Rakesh Kapoor, Anant Kumar, Amit Gupta, Sharma RK Dept. of Urology and Renal Transplantation SGPGIMS Lucknow.
Purpose To evaluate the outcomes of bilateral pretransplant nephrectomy (BPN) for small kidneys using bilateral dorsal lumbotomy (BDL) or transperitoneal laparoscopy (TL). Patients and Methods FIfty eight patients with end stage renal disease and small kidneys underwent BPN due to various indications, uncontrolled hypertension being the predominant in majority of cases. There were 38 patients in BDL group and 20 in TL group. The preoperative, intra-perative variables and postoperative outcomes were analyzed and compared between the two groups. Results The mean age of the and male : female ratio was comparable in both groups. The mean size of the kidneys removed were 7.4 cm and 8.2 cm respectively in Groups 1 and 2 respectively. Operative time was longer in group 2 (210 min, range 160-240) compared to Group 1(112 min, range 90-150 min) (p=0.0004). The postoperative pain, blood transfusion rate, wound and pulmonary complications were similar between two groups. Bowel function recovered earlier in BDL group compared to TL group (19 vs. 37 hrs, P <0.0001). The total cost for the nephrectomy by laparoscopy was 3.5 times that of dorsal lumbotomy. The mean time interval between nephrectomy and transplant was similar in both groups. Conclusions Bilateral dorsal lumbotomy appears to score over laparoscopic approach in pretransplant nephrectomy for small kidneys because of lesser operative time, earlier bowel recovery and lesser cost.
Copyright © 2009 by The Indian Society of Organ Transplantation
Indian J Transplant 2009; 3: 26-40
Laparoscopic Vs open donor nephrectomy in live related renal transplantation: Comparison of recipient outcome Muruganandham K, Ruchir Maheshwari, Aneesh Srivastava, Deepak Dubey, Rakesh Kapoor, Anant Kumar, Amit Gupta, Sharma RK Dept. of Urology and Renal Transplantation SGPGIMS Lucknow.
Objective To retrospectively compare the recipient outcomes in live related renal transplantion with kidneys retrieved by either laparoscopic or open approach. Methods We reviewed the donor and recipient records of 350 live related renal transplantation performed by laparoscopic donor nephrectomy (LLDN) in our centre from Jan 2000 to March 2007 and compared the recipient outcome with 270 open live donor nephrectomies (OLDN) performed during the same period. Early renal function was evaluated by serum creatinine on post operative day 1,3,5,7 and time for creatinine to reach nadir level. Long term outcome were evaluated by serum creatinine at 1,3,6,12 months and patients graft survival at 1,2 and 3 years follow up. Results The donor & recipient age, sex, body mass index and number of HLA mismatches were similar between the two groups. No differences were found either in mean serum creatinine levels on days 1,3,5,7 (2.36 mg%, 1.72 mg%, 1.70 mg% and 1.69 mg% respectively in the LLDN and comparable to that in the OLDN). Serum creatinine and rejection episodes at 1 year and patient and graft survival at 1,2, & 3 years were also similar in the two groups. Conclusions Early and long term renal function, patient and graft survival in live related renal transplantation are comparable when kidneys are retrieved by either a laparoscopic or an open surgical technique.
Indian Journal of Transplantation
Dorsal lumbotomy versus laparoscopy for pretransplant bilateral nephrectomy of small kidneys Muruganandham K, Ruchir Maheshwari, Aneesh Srivastava, Deepak Dubey, Rakesh Kapoor, Anant Kumar, Amit Gupta, Sharma RK Dept. of Urology and Renal Transplantation SGPGIMS Lucknow.
Purpose To evaluate the outcomes of bilateral pretransplant nephrectomy (BPN) for small kidneys using bilateral dorsal lumbotomy (BDL) or transperitoneal laparoscopy (TL). Patients and Methods FIfty eight patients with end stage renal disease and small kidneys underwent BPN due to various indications, uncontrolled hypertension being the predominant in majority of cases. There were 38 patients in BDL group and 20 in TL group. The preoperative, intra-perative variables and postoperative outcomes were analyzed and compared between the two groups. Results The mean age of the and male : female ratio was comparable in both groups. The mean size of the kidneys removed were 7.4 cm and 8.2 cm respectively in Groups 1 and 2 respectively. Operative time was longer in group 2 (210 min, range 160-240) compared to Group 1(112 min, range 90-150 min) (p=0.0004). The postoperative pain, blood transfusion rate, wound and pulmonary complications were similar between two groups. Bowel function recovered earlier in BDL group compared to TL group (19 vs. 37 hrs, P <0.0001). The total cost for the nephrectomy by laparoscopy was 3.5 times that of dorsal lumbotomy. The mean time interval between nephrectomy and transplant was similar in both groups. Conclusions Bilateral dorsal lumbotomy appears to score over laparoscopic approach in pretransplant nephrectomy for small kidneys because of lesser operative time, earlier bowel recovery and lesser cost.
Copyright © 2009 by The Indian Society of Organ Transplantation
Indian J Transplant 2009; 3: 26-40
Laparoscopic Vs open donor nephrectomy in live related renal transplantation: Comparison of recipient outcome Muruganandham K, Ruchir Maheshwari, Aneesh Srivastava, Deepak Dubey, Rakesh Kapoor, Anant Kumar, Amit Gupta, Sharma RK Dept. of Urology and Renal Transplantation SGPGIMS Lucknow.
Objective To retrospectively compare the recipient outcomes in live related renal transplantion with kidneys retrieved by either laparoscopic or open approach. Methods We reviewed the donor and recipient records of 350 live related renal transplantation performed by laparoscopic donor nephrectomy (LLDN) in our centre from Jan 2000 to March 2007 and compared the recipient outcome with 270 open live donor nephrectomies (OLDN) performed during the same period. Early renal function was evaluated by serum creatinine on post operative day 1,3,5,7 and time for creatinine to reach nadir level. Long term outcome were evaluated by serum creatinine at 1,3,6,12 months and patients graft survival at 1,2 and 3 years follow up. Results The donor & recipient age, sex, body mass index and number of HLA mismatches were similar between the two groups. No differences were found either in mean serum creatinine levels on days 1,3,5,7 (2.36 mg%, 1.72 mg%, 1.70 mg% and 1.69 mg% respectively in the LLDN and comparable to that in the OLDN). Serum creatinine and rejection episodes at 1 year and patient and graft survival at 1,2, & 3 years were also similar in the two groups. Conclusions Early and long term renal function, patient and graft survival in live related renal transplantation are comparable when kidneys are retrieved by either a laparoscopic or an open surgical technique.