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- Title
Intraoperative fluid management in laparoscopic live-donor nephrectomy: challenging the dogma.
- Authors
Bergman, S.; Feldman, L. S.; Carli, F.; Anidjar, M.; Vassiliou, M. C.; Andrew, C. G.; Stanbridge, D. D.; Fried, G. M.
- Abstract
<bold>Background: </bold>Patients undergoing laparoscopic live donor nephrectomy (LLDN) commonly receive large amounts of fluid intraoperatively to counter the negative effects of pneumoperitoneum on renal function. Our aim is to demonstrate that a low-volume fluid management strategy does not adversely affect donor or recipient outcomes.<bold>Methods: </bold>Fifty-two patients underwent LLDN between December 2000 and January 2004. Data were collected in prospective databases, and augmented with retrospective medical record review. Donors were divided into two groups: the fluid-load group (n = 24) received > 10 ml/kg/h of intravenous crystalloids intraoperatively, while the fluid-restriction group (n = 28) received < 10 m/kg/h.<bold>Results: </bold>Donors in the fluid-restriction group had a lower intraoperative urine output. There were no differences in postoperative creatinine levels (117.5 micromol/L vs 121.5 micromol/L, p = 0.8) or complications (4.2% vs 7.1%, p = 0.9). In the recipients, there were no differences in postoperative creatinine levels up to 12 months, incidence of delayed graft function (18% vs 10%, p = 0.7) or acute rejection (9% vs 5%, p = 1.0) between groups.<bold>Conclusion: </bold>Lower volume fluid management strategies in LLDN do not appear to worsen recipient outcomes nor are they detrimental to the donors.
- Subjects
LAPAROSCOPIC surgery; LAPAROSCOPY; BODY fluids; ARTIFICIAL pneumoperitoneum; ORGAN donors; ORGAN donation; COMPARATIVE studies; FLUID therapy; KIDNEY transplantation; LONGITUDINAL method; RESEARCH methodology; INTRAOPERATIVE care; MEDICAL cooperation; RESEARCH; SURGICAL complications; EVALUATION research; RETROSPECTIVE studies; NEPHRECTOMY
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2004, Vol 18, Issue 11, p1625
- ISSN
1866-6817
- Publication type
journal article
- DOI
10.1007/s00464-004-8811-3