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



Título del documento: The effect of kidney morcellation on operative time, incision complications, and postoperative analgesia after laparoscopic nephrectomy
Revue: International braz j urol
Base de datos: PERIÓDICA
Número de sistema: 000296964
ISSN: 1677-5538
Autores: 1




Instituciones: 1University of California, Department of Urology, San Francisco, California. Estados Unidos de América
Año:
Periodo: May-Jun
Volumen: 32
Número: 3
Paginación: 273-280
País: Brasil
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Caso clínico, analítico
Resumen en inglés 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
Disciplinas: Medicina
Palabras clave: Cirugía,
Nefrología,
Nefrectomía,
Dolor,
Laparoscopia
Keyword: Medicine,
Nephrology,
Surgery,
Nephrectomy,
Laparoscopy,
Pain
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