A cost-effective technique for pure laparoscopic live donor nephrectomy
Autor(a) principal: | |
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Data de Publicação: | 2006 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | International Braz J Urol (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382006000100004 |
Resumo: | OBJECTIVE: Compare two different techniques for laparoscopic live donor nephrectomy (LDN), related to the operative costs and learning curve. MATERIALS AND METHODS: Between April/2000 and October/2003, 61 patients were submitted to LDN in 2 different reference centers in kidney transplantation. At center A (CA), 11 patients were operated by a pure transperitoneal approach, using Hem-O-Lok<FONT FACE=Symbol>Ò</FONT> clips for the renal pedicle control and the specimens were retrieved manually, without using endobags. At center B (CB), 50 patients were also operated by a pure transperitoneal approach, but the renal pedicles were controlled with endo-GIA appliers and the specimens were retrieved using endobags. RESULTS: Operative time (231 ± 39 min vs. 179 ± 30 min; p < 0.000), warm ischemia time (5.85 ± 2.85 min vs. 3.84 ± 3.84 min; p = 0.002) and blood loss (214 ± 98 mL vs. 141 ± 82 mL; p = 0.02) were statistically better in CB, when compared to CA. Discharge time was similar in both centers. One major complication was observed in both centers, leading to an open conversion in CA (9.1%). One donor death occurred in CB (2%). Regarding the recipients, no statistical difference was observed in all parameters analyzed. There was an economy of US$1.440 in each procedure performed in CA, when compared to CB. CONCLUSIONS: Despite the learning curve, the technique adopted by CA, showed no deleterious results to the donors and recipients when compared with the CB. On the other hand, this technique was cheaper than the technique performed in the CB, representing an attractive alternative for LDN, mainly in developing centers. |
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A cost-effective technique for pure laparoscopic live donor nephrectomykidney transplantationnephrectomylaparoscopycosts and cost analysisOBJECTIVE: Compare two different techniques for laparoscopic live donor nephrectomy (LDN), related to the operative costs and learning curve. MATERIALS AND METHODS: Between April/2000 and October/2003, 61 patients were submitted to LDN in 2 different reference centers in kidney transplantation. At center A (CA), 11 patients were operated by a pure transperitoneal approach, using Hem-O-Lok<FONT FACE=Symbol>Ò</FONT> clips for the renal pedicle control and the specimens were retrieved manually, without using endobags. At center B (CB), 50 patients were also operated by a pure transperitoneal approach, but the renal pedicles were controlled with endo-GIA appliers and the specimens were retrieved using endobags. RESULTS: Operative time (231 ± 39 min vs. 179 ± 30 min; p < 0.000), warm ischemia time (5.85 ± 2.85 min vs. 3.84 ± 3.84 min; p = 0.002) and blood loss (214 ± 98 mL vs. 141 ± 82 mL; p = 0.02) were statistically better in CB, when compared to CA. Discharge time was similar in both centers. One major complication was observed in both centers, leading to an open conversion in CA (9.1%). One donor death occurred in CB (2%). Regarding the recipients, no statistical difference was observed in all parameters analyzed. There was an economy of US$1.440 in each procedure performed in CA, when compared to CB. CONCLUSIONS: Despite the learning curve, the technique adopted by CA, showed no deleterious results to the donors and recipients when compared with the CB. On the other hand, this technique was cheaper than the technique performed in the CB, representing an attractive alternative for LDN, mainly in developing centers.Sociedade Brasileira de Urologia2006-02-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382006000100004International braz j urol v.32 n.1 2006reponame:International Braz J Urol (Online)instname:Sociedade Brasileira de Urologia (SBU)instacron:SBU10.1590/S1677-55382006000100004info:eu-repo/semantics/openAccessSiqueira Jr,Tiberio MMitre,Anuar I.Simoes,Fabiano A.Maciel,Andre F.Ferraz,Alvaro M.Arap,Samieng2006-06-01T00:00:00Zoai:scielo:S1677-55382006000100004Revistahttp://www.brazjurol.com.br/ONGhttps://old.scielo.br/oai/scielo-oai.php||brazjurol@brazjurol.com.br1677-61191677-5538opendoar:2006-06-01T00:00International Braz J Urol (Online) - Sociedade Brasileira de Urologia (SBU)false |
dc.title.none.fl_str_mv |
A cost-effective technique for pure laparoscopic live donor nephrectomy |
title |
A cost-effective technique for pure laparoscopic live donor nephrectomy |
spellingShingle |
A cost-effective technique for pure laparoscopic live donor nephrectomy Siqueira Jr,Tiberio M kidney transplantation nephrectomy laparoscopy costs and cost analysis |
title_short |
A cost-effective technique for pure laparoscopic live donor nephrectomy |
title_full |
A cost-effective technique for pure laparoscopic live donor nephrectomy |
title_fullStr |
A cost-effective technique for pure laparoscopic live donor nephrectomy |
title_full_unstemmed |
A cost-effective technique for pure laparoscopic live donor nephrectomy |
title_sort |
A cost-effective technique for pure laparoscopic live donor nephrectomy |
author |
Siqueira Jr,Tiberio M |
author_facet |
Siqueira Jr,Tiberio M Mitre,Anuar I. Simoes,Fabiano A. Maciel,Andre F. Ferraz,Alvaro M. Arap,Sami |
author_role |
author |
author2 |
Mitre,Anuar I. Simoes,Fabiano A. Maciel,Andre F. Ferraz,Alvaro M. Arap,Sami |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Siqueira Jr,Tiberio M Mitre,Anuar I. Simoes,Fabiano A. Maciel,Andre F. Ferraz,Alvaro M. Arap,Sami |
dc.subject.por.fl_str_mv |
kidney transplantation nephrectomy laparoscopy costs and cost analysis |
topic |
kidney transplantation nephrectomy laparoscopy costs and cost analysis |
description |
OBJECTIVE: Compare two different techniques for laparoscopic live donor nephrectomy (LDN), related to the operative costs and learning curve. MATERIALS AND METHODS: Between April/2000 and October/2003, 61 patients were submitted to LDN in 2 different reference centers in kidney transplantation. At center A (CA), 11 patients were operated by a pure transperitoneal approach, using Hem-O-Lok<FONT FACE=Symbol>Ò</FONT> clips for the renal pedicle control and the specimens were retrieved manually, without using endobags. At center B (CB), 50 patients were also operated by a pure transperitoneal approach, but the renal pedicles were controlled with endo-GIA appliers and the specimens were retrieved using endobags. RESULTS: Operative time (231 ± 39 min vs. 179 ± 30 min; p < 0.000), warm ischemia time (5.85 ± 2.85 min vs. 3.84 ± 3.84 min; p = 0.002) and blood loss (214 ± 98 mL vs. 141 ± 82 mL; p = 0.02) were statistically better in CB, when compared to CA. Discharge time was similar in both centers. One major complication was observed in both centers, leading to an open conversion in CA (9.1%). One donor death occurred in CB (2%). Regarding the recipients, no statistical difference was observed in all parameters analyzed. There was an economy of US$1.440 in each procedure performed in CA, when compared to CB. CONCLUSIONS: Despite the learning curve, the technique adopted by CA, showed no deleterious results to the donors and recipients when compared with the CB. On the other hand, this technique was cheaper than the technique performed in the CB, representing an attractive alternative for LDN, mainly in developing centers. |
publishDate |
2006 |
dc.date.none.fl_str_mv |
2006-02-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382006000100004 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382006000100004 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/S1677-55382006000100004 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Urologia |
publisher.none.fl_str_mv |
Sociedade Brasileira de Urologia |
dc.source.none.fl_str_mv |
International braz j urol v.32 n.1 2006 reponame:International Braz J Urol (Online) instname:Sociedade Brasileira de Urologia (SBU) instacron:SBU |
instname_str |
Sociedade Brasileira de Urologia (SBU) |
instacron_str |
SBU |
institution |
SBU |
reponame_str |
International Braz J Urol (Online) |
collection |
International Braz J Urol (Online) |
repository.name.fl_str_mv |
International Braz J Urol (Online) - Sociedade Brasileira de Urologia (SBU) |
repository.mail.fl_str_mv |
||brazjurol@brazjurol.com.br |
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1750318069459189760 |