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Gavrilovska-Brzanov A, Stavridis S, Dohchev S, Mijovska MM, Petrusheva-Panovska A, Trifunovski A, Janculev J, Trajkovski D, Stankov V, Srceva MJ, Brzanov N. Laparoscopic Donor Nephrectomy in the Republic of North Macedonia. Pril (Makedon Akad Nauk Umet Odd Med Nauki) 2023; 44:65-71. [PMID: 37453116 DOI: 10.2478/prilozi-2023-0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
Introduction: Hand-assisted laparoscopic living donor nephrectomy has become the technique of choice for living donor kidney donations. Since 2018, 30 procedures have been performed at our clinic using this technique. The goal of this comparative analysis was to determine how surgical technique, specifically, hand-assisted laparoscopic living donor nephrectomy with hand assistance may affect early graft function when compared to open classical nephrectomy. Material and methods: Retrospective analyses were performed, comparing the two techniques of kidney donation. Kidney transplantation was performed with the open standard technique in both groups. The primary outcome was early graft function, and levels of urine output, and plasma creatinine were analyzed at three time points. A secondary outcome was the quality of the operative technique, which was determined by the time of warm ischemia, blood loss, and duration of surgery. Additionally, we noted all complications, length of hospital stay, and patient satisfaction. Results: In terms of warm ischemia time, there was no statistically significant difference between donors in both groups. It is important to note that in 2 recipients from Group II we did not observe diuresis at the conclusion of the operation. The recipients' diuresis was 515 ml ± 321SD in group I and 444 ml ± 271SD in group II. At 3, 12, and 36 hours postoperatively, there were statistically significant differences in the average serum creatinine values (p 0.05) in favor of group I. Similar results were observed in the second time measurement at 12 h and the third time measurement at 36 h for serum urea levels in recipients. The difference in serum urea values between the recipients in the groups at the first measurement (3h) following surgery was not statistically significant. Conclusion: Hand-assisted laparoscopic donor nephrectomy is recognized as a safe and effective treatment. Donors in this situation have a different profile from other surgical patients; hence, they do not undergo surgery due to their own medical condition but for an altruistic reason, and with hand-assisted living donor nephrectomy. Such patients receive all the advantages of minimally invasive surgery. The two main objectives of a donor nephrectomy are to give the recipient the best possible kidney and to ensure the donor's complete safety.
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Affiliation(s)
- Aleksandra Gavrilovska-Brzanov
- 1University Clinic for Traumatology, Orthopedic disease, Anesthesiology, Reanimation and Intensive Care Medicine and Emergency department, Clinical Center Mother Theresa Faculty of Medicine, University "Ss. Cyril and Methodius", Skopje, RN Macedonia
| | - Sotir Stavridis
- 2University Clinic for Urology, Clinical Center Mother Theresa, Faculty of Medicine, University "Ss. Cyril and Methodius", Skopje, RN Macedonia
| | - Sasho Dohchev
- 2University Clinic for Urology, Clinical Center Mother Theresa, Faculty of Medicine, University "Ss. Cyril and Methodius", Skopje, RN Macedonia
| | | | - Aleksandra Petrusheva-Panovska
- 1University Clinic for Traumatology, Orthopedic disease, Anesthesiology, Reanimation and Intensive Care Medicine and Emergency department, Clinical Center Mother Theresa Faculty of Medicine, University "Ss. Cyril and Methodius", Skopje, RN Macedonia
| | - Aleksandar Trifunovski
- 2University Clinic for Urology, Clinical Center Mother Theresa, Faculty of Medicine, University "Ss. Cyril and Methodius", Skopje, RN Macedonia
| | - Josif Janculev
- 2University Clinic for Urology, Clinical Center Mother Theresa, Faculty of Medicine, University "Ss. Cyril and Methodius", Skopje, RN Macedonia
| | - Dimitar Trajkovski
- 2University Clinic for Urology, Clinical Center Mother Theresa, Faculty of Medicine, University "Ss. Cyril and Methodius", Skopje, RN Macedonia
| | - Viktor Stankov
- 2University Clinic for Urology, Clinical Center Mother Theresa, Faculty of Medicine, University "Ss. Cyril and Methodius", Skopje, RN Macedonia
| | - Marija Jovanovski Srceva
- 1University Clinic for Traumatology, Orthopedic disease, Anesthesiology, Reanimation and Intensive Care Medicine and Emergency department, Clinical Center Mother Theresa Faculty of Medicine, University "Ss. Cyril and Methodius", Skopje, RN Macedonia
| | - Nikola Brzanov
- 1University Clinic for Traumatology, Orthopedic disease, Anesthesiology, Reanimation and Intensive Care Medicine and Emergency department, Clinical Center Mother Theresa Faculty of Medicine, University "Ss. Cyril and Methodius", Skopje, RN Macedonia
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Laučytė-Cibulskienė A, Miglinas M, Želvys A, Čekauskas A. Successful laparoscopic living donor nephrectomy: first experience in Lithuania. Acta Med Litu 2019; 26:140-146. [PMID: 31632189 PMCID: PMC6779470 DOI: 10.6001/actamedica.v26i2.4035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 05/14/2019] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The aim of this paper is to share the initial results of LLDN in high-volume university centre that is performing laparoscopic nephrectomies for other indications. MATERIALS AND METHODS During 2017, four LLDNs were performed. The transperitoneal approach was used in all cases and the kidney was removed using a suprapubic incision. All donors and recipients were prospectively analysed within six-month follow-up. The patients' clinical, laboratory, and operation-related data were collected from direct interviews with them and from medical records. All patients signed written informed consent. RESULTS One male and three females donated their left kidneys by using the LLDN technique. The mean age was 58 ± 9 years; two of them with a history of previous cholecystectomy. All donated kidneys had a single renal artery and renal vein. Pre-operative average eGFR was 94.2 ± 7.1 ml/min/1.73 m2, immediately after LLDN 57.5 ± 10.3 ml/min/1.73 m2, after one month 56.0 ± 9.1 ml/min/1.73 m2. There were no intraoperative complications; surgery duration was 223.75 ± 21.74 min, the cold ischemia time was 77.5 ± 28.77 min, and the warm ischemia time 6.37 ± 3.14 min. There was one postoperative donor complication, one case of acute kidney injury, and one case of prolonged postoperative abdominal pain. The only recipient complication was one case of acute kidney rejection; there were no cases of delayed graft function. CONCLUSIONS Our initial experience confirms that LLDN is an approach that is easy to learn, especially in a high-volume university hospital with expertise in performing laparoscopic nephrectomies for other indications.
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Affiliation(s)
- Agnė Laučytė-Cibulskienė
- Clinic of Gastronenterology, Nephrourology, and Abdominal Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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Sharma PK, Vijay MK, Pandey PK, Goel A, Bera MK. Comparison of transperitoneal laparoscopic approach and retroperitoneoscopic-assisted open approach for right-sided donor nephrectomies: A single institution experience. INDIAN JOURNAL OF TRANSPLANTATION 2011. [DOI: 10.1016/s2212-0017(11)60036-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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