RESUMEN
AIM: To assess short term morbidity and renal function after robotic laparoscopic living donor nephrectomy. PATIENTS AND METHODS: We performed a retrospective analysis of 100 consecutives patients undergoing a robotic laparoscopic living donors nephrectomy. We analyzed isotopic measure of the renal function before and 4 months after surgery, the side, the number of arteries, the blood loss, the operative time and warm ischemia time. In the outcomes, we collected the complications, the length of stay, and for the receiver, the renal function recovery time, dialysis, survival and renal function at one year. RESULTS: Left kidney nephrectomy was performed in 85 patients and we observed 25 multiples renal arteries. Mean estimated blood loss was 0,8 g/dL. Mean operative time and warm ischemia time were respectively 174 ± 30 and 4.8 ± 1.7 minutes. Seven complications occured, with 2 major (Clavien-Dindo System). Mean length of stay was 5.1 ± 1.9 days. Mean glomerular filtration decrease was 26% and remains stable at one year after surgery. Grafts had an immediate renal function recovery for 99%, and were all functional after one year, with mean MDRD clearance of 57 ± 14mL/min. CONCLUSION: Robotic procedure in laparoscopic living donor nephrectomy seems to guarantee low morbidity and the stability of the renal function decrease of 26%.
Asunto(s)
Trasplante de Riñón , Laparoscopía/métodos , Donadores Vivos , Nefrectomía/métodos , Procedimientos Quirúrgicos Robotizados , Adulto , Pérdida de Sangre Quirúrgica , Femenino , Supervivencia de Injerto , Humanos , Riñón/irrigación sanguínea , Masculino , Persona de Mediana Edad , Tempo Operativo , Cuidados Preoperatorios , Estudios RetrospectivosRESUMEN
The antitumor agent Adriamycin (ADM) increases the sialic acid content of K 562 cell plasma membrane glycoconjugates. Total and neuraminidase-sensitive sialic acid are enhanced 3 to 4 times when expressed per 10(6) cells. This fact is a consequence of an increase in cell surface and in plasma membrane sialic acid density. Protein-bound and lipid-bound sialic acid are increased in the same way and exhibit the same ratio 90/10. After external radiolabelling by periodide-borotritide and neuraminidase-galactose oxidase-borotritide treatment, only some quantitative changes can be observed. Fractionation of gangliosides by thin layer chromatography gives the same results. Further experiments lead to the following conclusions: the hypersialylation cannot be explained by a G2-block in the cell cycle induced by ADM; it is not a consequence of a differentiation process; it is not observed in a population of adriamycin-resistant K 562 cells and can therefore be considered as a metabolic event linked to the cytotoxic activity of ADM.