The effect of kidney morcellation on operative time, incision complications, and postoperative analgesia after laparoscopic nephrectomy



Document title: The effect of kidney morcellation on operative time, incision complications, and postoperative analgesia after laparoscopic nephrectomy
Journal: International braz j urol
Database: PERIÓDICA
System number: 000296964
ISSN: 1677-5538
Authors: 1




Institutions: 1University of California, Department of Urology, San Francisco, California. Estados Unidos de América
Year:
Season: May-Jun
Volumen: 32
Number: 3
Pages: 273-280
Country: Brasil
Language: Inglés
Document type: Artículo
Approach: Caso clínico, analítico
English abstract INTRODUCTION: Compare the outcomes between kidney morcellation and two types of open specimen extraction incisions, several covariates need to be taken into consideration that have not yet been studied. MATERIALS AND METHODS: We retrospectively reviewed 153 consecutive patients who underwent laparoscopic nephrectomy at our institution, 107 who underwent specimen morcellation and 46 with intact specimen removal, either those with connected port sites with a muscle-cutting incision and those with a remote, muscle-splitting incision. Operative time, postoperative analgesia requirements, and incisional complications were evaluated using univariate and multivariate analysis, comparing variables such as patient age, gender, body mass index (BMI), laterality, benign versus cancerous renal conditions, estimated blood loss, specimen weight, overall complications, and length of stay. RESULTS: There was no significant difference for operative time between the 2 treatment groups (p = 0.65). Incision related complications occurred in 2 patients (4.4%) from the intact specimen group but none in the morcellation group (p = 0.03). Overall narcotic requirement was lower in patients with morcellated (41 mg) compared to intact specimen retrieval (66 mg) on univariate (p = 0.03) and multivariate analysis (p = 0.049). Upon further stratification, however, there was no significant difference in mean narcotic requirement between the morcellation and muscle-splitting incision subgroup (p = 0.14). CONCLUSION: Morcellation does not extend operative time, an
Disciplines: Medicina
Keyword: Cirugía,
Nefrología,
Nefrectomía,
Dolor,
Laparoscopia
Keyword: Medicine,
Nephrology,
Surgery,
Nephrectomy,
Laparoscopy,
Pain
Full text: Texto completo (Ver HTML)