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Retroperitoneoskopik Verici Nefrektomi Sonuçlarımız

Results of Retroperitoneoscopic Donor Nephrectomy at our Center

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DOI: 
DOI 10.5262/tndt.2010.1003.05
Abstract (2. Language): 
OBJECTIVE: Retroperitoneoscopic donor nephrectomy (RDN), a variation of laparoscopic donor nephrectomy technique, has been reported only by a few centers. Here, we aimed to present the preliminary results of RDN at our center. Materi al and Metho ds: Fifteen consecutive RDNs were performed at our center from December 2009 to June 2010. The data obtained included donor age, sex, body mass index (BMI), operative time (OT), warm ischemia time (WIT), blood loss, and intra- and postoperative complications. Res ults : Mean donor age was 42.2±9.4 years with a mean BMI of 25.6 kg/m2. 53% (n=8) of the donors were females and 47% (n=7) males. The left kidney was procured in 73% (n=11) of the donors. The reason for procurement of the right kidney was multiple arteries on the left in all cases. Mean OT was 138±34 min, mean WIT was 170±58 s, and mean blood loss was 140±45 ml. One patient was converted to open surgery due to vena cava injury. All kidneys were successfully transplanted. The average creatinine level on postoperative day 7 was 1.02±0.26 mg/dl compared to 0.64±0.16 mg/dl before the operation. The mean length of hospital stay was 4±0.9 days. None of patients encountered postoperative complications. Conclusio n: RDN can be performed with acceptable intraoperative morbidity. The results of our series support the safety of RDN.
Abstract (Original Language): 
Amaç: Son on yılda, verici nefrektomide standart yöntem laparoskopi olmuştur. Bununla birlikte laparoskopik tekniğin bir varyasyonu olan retroperitoneoskopik yöntem ancak belirli merkezlerde uygulanmaktadır. Bu çalışmada, 15 olguya uyguladığımız retroperitoneoskopik verici nefrektomi (RVN) deneyimimiz ve sonuçlarını sunduk. Gereç ve Yönte mLER: Aralık 2009-Haziran 2010 tarihleri arasında kliniğimizde 15 olguya RVN operasyonu uygulandı. Hasta verileri tıbbi kayıtlardan elde edildi. Verici yaşı, cinsiyeti, operasyondaki tahmini kan kaybı, sıcak iskemi süresi, hastanede kalış süresi, Vericinin operasyon öncesi ve operasyon sonrası birinci hafta, 1. ay ve 3. ay serum kreatinin düzeyleri, operasyon sırasında ve operasyon sonrası komplikasyonları değerlendirildi. Bulgular: Ortalama yaşı 42,2±9,4 (26-55) yıl olan 7’si erkek, 8’i kadın toplam 15 olguya RVN uygulandı. 11 olguda sol, 4 olguda ise sağ RVN uygulandı. Ortalama operasyon süresi 138±34 (70-195) dk idi. Ortalama sıcak iskemi süresi 170±58 (100-300) sn idi. Ortalama kan kaybı 140±45 (50-1200) ml idi. Sağ RVN yapılan bir hastada vena kava yaralanması nedeniyle açık ameliyata geçildi. Tüm böbrekler başarı ile nakledildiler. Operasyon sonrası hastanede kalış süresi ortalama 4±0,9 (3-6) gündü. Vericilerin operasyon öncesi kreatinin düzeyi ortalama 0,64±0,16 mg/dl, operasyon sonrası 1. haftada 1,02±0,26 mg/dL düzeyindeydi. Alıcıların kreatinin düzeyi ise operasyon sonrası 1. Haftada 1 mg/dL düzeyinde ve izlemlerinde aynı düzeyde izlendi. Operasyon sonrası komplikasyon izlenmedi. Sonuç: RVN, güvenli ve minimal invazif bir yöntemdir.
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