The use of laparoscopic nephrectomy in patients with autosomal dominant polycystic kidney disease

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Abstract


The study analyzed the results of treatment of 32 patients with autosomal dominant polycystic kidney disease (PKD). In the period from 2014 to 2016 these patients underwent nephrectomy for clinical indications and in preparation for renal transplantation. The first group (15 patients) performed open surgery using midline laparotomy and lumbotomy (16 operations), of which: bilateral nephrectomy - 11 (68.7%), monolateral nephrectomy - 5 (31.3%). In the second group (17 patients) to perform a monolateral nephrectomy used laparoscopic transabdominal access (24 operations). The average duration of laparoscopic and open surgical interventions were not significantly different and amounted to 146 ± 14 and 134±15 min (p > 0.05). The maximum size of the deleted polycystic-changed kidneys in the first group amounted to 22.5 ± 4.27 cm, in the second of 21.5 ± 3.9 cm (p > 0.05). The frequency of postoperative complications in the first and second groups consisted of 43.75% and 12.5%, respectively. Was observed in 1 (6.25%) case of lethal outcome in the first group. Average postoperative hospital stay in the first group 13-14 (to 13.7 ± 1.3), in the second - 7-8 (7.6 ± 0.4, p < 0.05). Patients after laparoscopic procedures activated in 2-3 days (2.5 ± 0.13) after open procedures on 4-5 (4.13 ± 0.39, p < 0.05). Laparoscopic technology can significantly reduce the frequency of postoperative complications and increase the possibility of the use of nephrectomy in the treatment of patients with PKD. Laparoscopic transabdominal approach is characterized by a more favorable course of the postoperative period after nephrectomy, can reduce the duration of inpatient treatment and to activate patients in the early stages.

Oleg N Reznik

Author for correspondence.
onreznik@gmail.com
Academician I.P. Pavlov First St Petersburg State Medical University of the Ministry of Healthcare of the Russian Federation
Russian Federation

doctor of medical science, Chief of Organ Transplant Department

Alexey N Ananiev

alexananyev13@gmail.com
Academician I.P. Pavlov First St Petersburg State Medical University of the Ministry of Healthcare of the Russian Federation
Russian Federation

candidate of medical science, head of Department of kidney transplantation

Evgeny S Nevirovich

nevirovich@gmail.com
Academician I.P. Pavlov First St Petersburg State Medical University of the Ministry of Healthcare of the Russian Federation
Russian Federation

candidate of medical science, head of the Oncology Department of the research center of urology

Vasily S Dayneko

dvsis@rambler.ru
Academician I.P. Pavlov First St Petersburg State Medical University of the Ministry of Healthcare of the Russian Federation
Russian Federation

surgeon of the Department of kidney transplantation

Andrey E Skvortsov

skvortsov.spb@gmail.com
Academician I.P. Pavlov First St Petersburg State Medical University of the Ministry of Healthcare of the Russian Federation
Russian Federation

candidate of medical science, head of the Surgery Department

Mikhail Yu Shiganov

orlanmaa@rambler.ru
Academician I.P. Pavlov First St Petersburg State Medical University of the Ministry of Healthcare of the Russian Federation
Russian Federation

candidate of medical science, head of Department of reanimation and intensive therapy

Denis O Kuzmin

saintdeni@gmail.com
Academician I.P. Pavlov First St Petersburg State Medical University of the Ministry of Healthcare of the Russian Federation
Russian Federation

surgeon of the Department of kidney transplantation

Alexey A Kutenkov

alexqut@gmail.com
Academician I.P. Pavlov First St Petersburg State Medical University of the Ministry of Healthcare of the Russian Federation
Russian Federation

surgeon of the Department of kidney transplantation

  • Akoh JA. Current management of autosomal dominant polycystic kidney disease. World J Nephrol. 2015;4(4):468-79. doi: 10.5527/wjn.v4.i4.468.
  • Chapman AB, Devuyst O, Eckardt KU, Gansevoort RT, Harris T, Horie S, et al. Autosomal-dominant polycystic kidney disease (ADPKD): executive summary from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney Int. 2015;88(1):17-27. doi: 10.1038/ki.2015.59.
  • Ермоленко В.М., Бтэрдэнэ С. Аутосомно-доминантная поликистозная болезнь почек: новые патогенетические и терапевтические аспекты // Нефрология и диализ. – 2008. – Т. 10. – № 2. – С. 111–122. [Ermolenko VM, Bterdene S. Autosomno-dominantnaya polikistoznaya bolezn’ pochek: novye patogeneticheskie i terapevticheskie aspekty. Nefrologiya i dializ. 2008;10(2):111-122. (In Russ.)]
  • Казимиров В.Г., Бутрин С.В., Сапожников А.Д. Трансплантация почки у больных с аутосомно-доминантным поликистозом почек. – Волгоград: Государственное учреждение «Издатель», 2003.– 112 с. [Kazimirov VG, Butrin SV, Sapozhnikov AD. Transplantatsiya pochki u bol’nykh s autosomno-dominantnym polikistozom pochek. Volgograd: Gosudarstvennoe uchrezhdenie “Izdatel’”; 2003. – 112 p. (In Russ.)]
  • Кутырина И.М. Поликистоз почек. «Нефрология» Национальное руководство. Ред. Н.А. Мухин. М.: ГЭОТАР-Медиа 2009: 508–512. [Kutyrina IM. Polikistoz pochek. “Nefrologiya” Natsional’noe rukovodstvo. Ed by N.A. Mukhin. Moscow: GEOTAR-Media; 2009: 508-512 p. (In Russ.)]
  • Chebib FT, Prieto M, Jung Y, Irazabal MV, et al. Native Nephrectomy in Renal Transplant Recipients with Autosomal Dominant Polycystic Kidney Disease. Transplant Direct. 2015;1(10):e43. doi: 10.1097/TXD.0000000000000554.
  • Cristea O, Yanko D, Felbel S, et al. Maximal kidney length predicts need for native nephrectomy in ADPKD patients undergoing renal transplantation. Can Urol Assoc J. 2014;8(7-8):278-282. doi: 10.5489/cuaj.2128.
  • Cohen D, Timsit MO, Chrétien Y, et al. Place of nephrectomy in patients with autosomal dominant polycystic kidney disease waiting for renal transplantation. Prog Urol. 2008;18(10):642-649. doi: 10.1016/j.purol.2008.06.004.
  • Patel MS, Kandula P, Wojciechowski D, et al. Trends in the management and outcomes of kidney transplantation for autosomal dominant polycystic kidney disease. J Transplant. 2014;(1):675-697. doi: 10.1155/2014/675697.
  • Shumate AM, Bahler CD, Goggins WC, et al. Native Nephrectomy with Renal Transplantation is Associated with a Decrease in Hypertension Medication Requirements for Autosomal Dominant Polycystic Kidney Disease. J Urol. 2016;195(1):141-146. doi: 10.1016/j.juro.2015.07.114.
  • Трушкин Р.Н., Лубенников А.Е., Сысоев А.М., Соколов А.А. Нефрэктомия у больных с терминальной стадией хронической почечной недостаточности и активным течением пиелонефрита // Экспериментальная и клиническая урология. – 2015. – № 4. – С. 104–109. [Trushkin R.N., Lubennikov A.E., Sysoev A.M., Sokolov A.A. Nefrektomiya u bol’nykh s terminal’noy stadiey khronicheskoy pochechnoy nedostatochnosti i aktivnym techeniem pielonefrita. Eksperimental’naya i klinicheskaya urologiya. 2015;(4):104-109. (In Russ.)]
  • Binsaleh S, Luke PP, Nguan C, Kapoor A. Comparison of laparoscopic and open nephrectomy for adult polycystic kidney disease: operative challenges and technique. Can J Urol. 2006;13(6): 3340-3345.
  • Bansal RK, Kapoor А. Laparoscopic nephrectomy for massive polycystic kidney disease: Updated technique and outcomes. Can Urol Assoc J. 2014;8(9-10):341-345. doi: 10.5489/cuaj.2097.
  • Eng M, Jones CM, Cannon RM, Marvin MR. Hand-assisted laparoscopic nephrectomy for polycystic kidney disease. JSLS. 2013; 17(2):279-284. doi: 10.4293/108680813X13654754535719.
  • Verhoest G, Delreux A, Mathieu R, et al. Transperitoneal Laparoscopic Nephrectomy for Autosomal Dominant Polycystic Kidney Disease. JSLS. 2012; 16(3):437442. doi: 10.4293/108680812X13462882736.

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