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Kidney Transplant II: Surgical Procedure01:26

Kidney Transplant II: Surgical Procedure

Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living donor...

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Laparoscopic partial nephrectomy in octogenarians.

Anil A Thomas1, Monish Aron, Adrian V Hernandez

  • 1Section of Laparoscopic and Robotic Surgery, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.

Urology
|August 18, 2009
PubMed
Summary
This summary is machine-generated.

Laparoscopic partial nephrectomy is safe and feasible for octogenarians. This minimally invasive procedure offers similar complication rates and renal function outcomes compared to younger patients, suggesting age alone is not a contraindication.

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Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Geriatric Medicine

Background:

  • The aging US population leads to more elderly patients with renal masses.
  • Partial nephrectomy is a common treatment for renal tumors.
  • Assessing the safety and feasibility in octogenarians is crucial.

Purpose of the Study:

  • To evaluate the safety and technical feasibility of laparoscopic partial nephrectomy in patients aged 80 years and older.
  • To determine if this procedure is justifiable in select octogenarians.
  • To compare outcomes in octogenarians versus younger patients.

Main Methods:

  • Retrospective review of 832 patients undergoing laparoscopic partial nephrectomy (1999-2007).
  • Comparison of demographics, perioperative data, and renal function between octogenarians (>=80 years) and younger patients (<80 years).

Main Results:

  • 41 octogenarians and 791 younger patients were analyzed.
  • Octogenarians had higher comorbidity scores but similar intraoperative and postoperative complication rates.
  • Despite lower preoperative kidney function, the decline in glomerular filtration rate was comparable between groups.

Conclusions:

  • Laparoscopic partial nephrectomy is safe and technically feasible in carefully selected octogenarians.
  • Perioperative morbidity rates are similar to those in younger patients.
  • Age should not be an absolute contraindication for this procedure.