Objective: This study aims to determine surgical complications and graft outcome in children undergoing renal transplantation at Cayetano Heredia National Hospital (CHNH). Materials and Methods: A case study series fo...Objective: This study aims to determine surgical complications and graft outcome in children undergoing renal transplantation at Cayetano Heredia National Hospital (CHNH). Materials and Methods: A case study series focused on the incidence of surgical complications and graft outcome in pediatric patients with end stage renal disease (ESRD) who underwent renal transplant (RT) between December 2007 and March 2011. Results: The study described 29 pediatric transplant patients whose average age was 13.69 ± 3.38 (6.2-17.9) years. The etiology of end stage renal disease (ESRD) was renal hypoplasia in 12 patients (41.38%), primary glomerulopathy in 10 patients (34.48%), obstructive uropathy in 4 patients (13.79%), vasculitis in 2 patients (6.9%) and hemolytic uremic syndrome (HUS) in 1 (3.45%) patient. There were 11 surgical complications (34.48%): 2 cases of arterial thrombosis, 3 cases of urinary fistula, 3 of lymphocele, 1 of venous thrombosis, urinoma and perineal collection. The follow-up time was 15.84 ± 12.19 months. Graft survival at 12, 24, and 40 months was 89.29%, 77.16% and 77.16%, respectively. Conclusion: Surgical complications and graft survival in pediatric renal transplantation in our series did not differ from other published series.展开更多
AIM To compare laparoscopic and open living donor nephrectomy,based on the results from a single center during a decade.METHODS This is a retrospective review of all living donor nephrectomies performed at the Massach...AIM To compare laparoscopic and open living donor nephrectomy,based on the results from a single center during a decade.METHODS This is a retrospective review of all living donor nephrectomies performed at the Massachusetts General Hospital,Harvard Medical School,Boston,between 1/1998- 12/2009. Overall there were 490 living donors,with 279 undergoing laparoscopic living donor nephrectomy(LLDN) and 211 undergoing open donor nephrectomy(OLDN). Demographic data,operating room time,the effect of the learning curve,the number of conversions from laparoscopic to open surgery,donor preoperative glomerular filtration rate and creatinine(Cr),donor and recipient postoperative Cr,delayed graft function and donor complications were analyzed. Statistical analysis was performed.RESULTS Overall there was no statistically significant difference between the LLDN and the OLDN groups regarding operating time,donor preoperative renal function,donor and recipient postoperative kidney function,delayed graft function or the incidence of major complications. When the last 100 laparoscopic cases were analyzed,there was a statistically significant difference regarding operating time in favor of the LLDN,pointing out the importance of the learning curve. Furthermore,another significant difference between the two groups was the decreased length of stay for the LLDN(2.87 d for LLDN vs 3.6 d for OLDN).CONCLUSION Recognizing the importance of the learning curve,this paper provides evidence that LLDN has a safety profile comparable to OLDN and decreased length of stay for the donor.展开更多
文摘Objective: This study aims to determine surgical complications and graft outcome in children undergoing renal transplantation at Cayetano Heredia National Hospital (CHNH). Materials and Methods: A case study series focused on the incidence of surgical complications and graft outcome in pediatric patients with end stage renal disease (ESRD) who underwent renal transplant (RT) between December 2007 and March 2011. Results: The study described 29 pediatric transplant patients whose average age was 13.69 ± 3.38 (6.2-17.9) years. The etiology of end stage renal disease (ESRD) was renal hypoplasia in 12 patients (41.38%), primary glomerulopathy in 10 patients (34.48%), obstructive uropathy in 4 patients (13.79%), vasculitis in 2 patients (6.9%) and hemolytic uremic syndrome (HUS) in 1 (3.45%) patient. There were 11 surgical complications (34.48%): 2 cases of arterial thrombosis, 3 cases of urinary fistula, 3 of lymphocele, 1 of venous thrombosis, urinoma and perineal collection. The follow-up time was 15.84 ± 12.19 months. Graft survival at 12, 24, and 40 months was 89.29%, 77.16% and 77.16%, respectively. Conclusion: Surgical complications and graft survival in pediatric renal transplantation in our series did not differ from other published series.
文摘AIM To compare laparoscopic and open living donor nephrectomy,based on the results from a single center during a decade.METHODS This is a retrospective review of all living donor nephrectomies performed at the Massachusetts General Hospital,Harvard Medical School,Boston,between 1/1998- 12/2009. Overall there were 490 living donors,with 279 undergoing laparoscopic living donor nephrectomy(LLDN) and 211 undergoing open donor nephrectomy(OLDN). Demographic data,operating room time,the effect of the learning curve,the number of conversions from laparoscopic to open surgery,donor preoperative glomerular filtration rate and creatinine(Cr),donor and recipient postoperative Cr,delayed graft function and donor complications were analyzed. Statistical analysis was performed.RESULTS Overall there was no statistically significant difference between the LLDN and the OLDN groups regarding operating time,donor preoperative renal function,donor and recipient postoperative kidney function,delayed graft function or the incidence of major complications. When the last 100 laparoscopic cases were analyzed,there was a statistically significant difference regarding operating time in favor of the LLDN,pointing out the importance of the learning curve. Furthermore,another significant difference between the two groups was the decreased length of stay for the LLDN(2.87 d for LLDN vs 3.6 d for OLDN).CONCLUSION Recognizing the importance of the learning curve,this paper provides evidence that LLDN has a safety profile comparable to OLDN and decreased length of stay for the donor.
