| Randomized clinical trial of laparoscopic versus open donor nephrectomy. | |
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MedLine Citation:
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PMID: 19937983 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: This randomized controlled trial was designed to determine the safety and efficacy of laparoscopic donor nephrectomy (LDN) in comparison with short-incision open donor nephrectomy (ODN). METHODS: Eighty-four live kidney donors were randomized in a 2 : 1 ratio to LDN (56 patients) or short-incision ODN without rib resection (28). Primary endpoints were pain relief and duration of inpatient stay. RESULTS: There was no donor death or allograft thrombosis in either group. The first warm ischaemic time median (range) 4 (2-7) versus 2 (1-5) min; P = 0.001) and the duration of operation (160 (110-250) versus 150 (90-200); P = 0.004) were longer for LDN. LDN led to a reduction in parenteral morphine requirement 59 (6-136) versus 90 (35-312) mg; P = 0.001) and hospital stay (4 (2-6) versus 6 (2-9) days; P = 0.001), and earlier return to employment (42 (14-84) versus 66.5 (14-112) days; P = 0.004). Postoperative respiratory function was improved after LDN. There were more postoperative complications per donor in the ODN group (0.6(0.7) versus 0.3(0.5); P = 0.033). At a median follow-up of 74 months, there were no differences in renal function or allograft survival between the groups. CONCLUSION: LDN removes some of the disincentives to live donation without compromising the outcome of the recipient transplant. |
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Authors:
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M L Nicholson; M Kaushik; G R R Lewis; N R Brook; A Bagul; M D Kay; S J Harper; R Elwell; P S Veitch |
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Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The British journal of surgery Volume: 97 ISSN: 1365-2168 ISO Abbreviation: Br J Surg Publication Date: 2010 Jan |
Date Detail:
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Created Date: 2009-12-17 Completed Date: 2009-12-31 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372553 Medline TA: Br J Surg Country: England |
Other Details:
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Languages: eng Pagination: 21-8 Citation Subset: AIM; IM |
Copyright Information:
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Copyright 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. |
Affiliation:
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Transplant Surgery Group, Department of Infection, Immunity and Inflammation, University of Leicester, Leicester General Hospital, Gwendolen Road, Leicester LE5 4PW, UK. mln2@le.ac.uk |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Analgesics, Opioid
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therapeutic use Female Humans Intraoperative Complications / etiology Kidney Transplantation / methods* Laparoscopy / methods* Length of Stay Living Donors* Male Middle Aged Morphine / therapeutic use Nephrectomy / methods* Pain, Postoperative / prevention & control Postoperative Complications / etiology Prognosis Respiratory Function Tests Tissue and Organ Harvesting / methods* |
| Chemical | |
Reg. No./Substance:
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0/Analgesics, Opioid; 57-27-2/Morphine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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