Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Konkret geht es um den Diabetes-Patienten mit kardiovaskulären Erkrankungen oder Risiken, die Herzinsuffizienz sowie die kardiovaskuläre Primär- und Sekundärprävention. Sind Sie hier schon auf dem neuesten Stand? Unsere Experten beleuchten, wo und warum das bisherige Procedere geändert werden soll und was in der Praxis sinnvoll ist. Holen Sie sich Ihr Update und 2 CME-Punkte beim MMW-Webinar am 24. April von 17.30 bis 19 Uhr. 
Erweiterte Suche
Anmelden
nach oben
Surgical Endoscopy
Erschienen in: Surgical Endoscopy 11/2015

01.11.2015 | Review

Donor safety in live donor laparoscopic liver procurement: systematic review and meta-analysis

verfasst von: Mohamed Bekheit, Philipe-Abrahim Khafagy, Petru Bucur, Khaled Katri, Ahmed Elgendi, Wael Nabil Abdel-salam, Eric Vibert, El-said El-kayal

Erschienen in: Surgical Endoscopy | Ausgabe 11/2015

Einloggen, um Zugang zu erhalten

Abstract

Background

Donor safety is a major concern in live organ donation. Live donor laparoscopic liver procurement is an advanced surgical procedure that is performed in highly specialized centers. Since its first report, not much progress has been endeavored for that procedure.

Methods

We planned to include all the randomized and comparative nonrandomized studies. Patients’ population: live donors who are submitted to organ procurement via laparoscopy.

Results

Out of 5,636 records retrieved from the literature, only seven nonrandomized studies were included in this review, which encompassed 418 patients, 151 patients of whom underwent laparoscopic procurement. The quality scores for the included studies ranged from 66 to 76 %. The operative time was significantly shorter in the conventional open group (SD = 0.863, 95 % CI 0.107–1.819). Blood loss in the laparoscopic group was comparable with the conventional open approach (SD = −0.307, 95 % CI −0.807 to 0.192). In subgroup analysis, laparoscopy was protective against blood loss in laparoscopic parenchymal dissection (SD = −1.168, 95 % CI −1.758 to −0.577). The hospital stay was equal in both groups. Patients in laparoscopic group consumed fewer analgesics compared with conventional open group (SD = −0.33, 95 % CI −0.63 to −0.03). Analgesics use was lower in the laparoscopic group compared with the conventional approach. The rate of Clavien complications was equal in both groups (OR 0.721, 95 % CI 0.303–1.716). No difference was found between subgroup analysis based on the harvested liver lobe. Funnel plot and statistical methods used revealed low probability of publication BIAS.

Conclusions

Live donor laparoscopic liver procurement could be as safe as the conventional open approach. Lower blood loss and lower consumtion of analgesics might be offered in the laparoscopic approach.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Buckley T (2000) The shortage of solid organs for transplantation in Hong Kong: part of a worldwide problem. Hong Kong Med J 6:399–408PubMed
2.
Yamaoka Y, Morimoto T, Inamoto T, Tanaka A, Honda K, Ikai I et al (1995) Safety of the donor in living-related liver transplantation-an analysis of 100 parental donors. Transplantation 59:224–225CrossRefPubMed
3.
4.
5.
Renz JF, Roberts JP (2000) Long-term complications of living donor liver transplantation. Liver Transpl 6:s73–s76CrossRefPubMed
6.
Cherqui D, Soubrane O, Husson E, Barshasz E, Vignaux O, Ghimouz M et al (2002) Laparoscopic living donor hepatectomy for liver transplantation in children. Lancet 359:392–396CrossRefPubMed
7.
Dindo D, Demartines N, Clavien P-A (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205PubMedCentralCrossRefPubMed
8.
Higgins JP, Green S et al (2008) Cochrane handbook for systematic reviews of interventions. Wiley, ChichesterCrossRef
9.
Kjaergard LL, Villumsen J, Gluud C (2001) Reported methodologic quality and discrepancies between large and small randomized trials in meta-analyses. Ann Intern Med 135:982–989CrossRefPubMed
10.
Moher D, Pham B, Jones A, Cook DJ, Jadad AR, Moher M et al (1998) Does quality of reports of randomised trials affect estimates of intervention efficacy reported in meta-analyses? Lancet 352:609–613CrossRefPubMed
11.
Schulz KF, Chalmers I, Hayes RJ, Altman DG (1995) Empirical evidence of bias: dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA 273:408–412CrossRefPubMed
12.
Wood L, Egger M, Gluud LL, Schulz KF, Jüni P, Altman DG et al (2008) Empirical evidence of bias in treatment effect estimates in controlled trials with different interventions and outcomes: meta-epidemiological study. BMJ Br Med J 336:601CrossRef
13.
Hozo SP, Djulbegovic B, Hozo I (2005) Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol 5:13PubMedCentralCrossRefPubMed
14.
DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7:177–188CrossRefPubMed
15.
DeMets DL (1987) Methods for combining randomized clinical trials: strengths and limitations. Stat Med 6:341–348CrossRefPubMed
16.
Higgins J, Thompson SG (2002) Quantifying heterogeneity in a meta-analysis. Stat Med 21:1539–1558CrossRefPubMed
17.
Newell DJ (1992) Intention-to-treat analysis: implications for quantitative and qualitative research. Int J Epidemiol 21:837–841CrossRefPubMed
18.
Sweeting MJ, Sutton JA, Lambert CP (2004) What to add to nothing? Use and avoidance of continuity corrections in meta-analysis of sparse data. Stat Med 23:1351–1375CrossRefPubMed
19.
Macaskill P, Walter SD, Irwig L (2001) A comparison of methods to detect publication bias in meta-analysis. Stat Med 20:641–654CrossRefPubMed
20.
21.
Sterne JA, Egger M (2001) Funnel plots for detecting bias in meta-analysis: guidelines on choice of axis. J Clin Epidemiol 54:1046–1055CrossRefPubMed
22.
Kim K, Jung D, Park K, Lee Y, Kim D, Kim K et al (2011) Comparison of open and laparoscopic live donor left lateral sectionectomy. Br J Surg 98:1302–1308CrossRefPubMed
23.
Baker TB, Jay CL, Ladner DP, Preczewski LB, Clark L, Holl J et al (2009) Laparoscopy-assisted and open living donor right hepatectomy: a comparative study of outcomes. Surgery 146:817–825CrossRefPubMed
24.
Soubrane O, Cherqui D, Scatton O, Stenard F, Bernard D, Branchereau S et al (2006) Laparoscopic left lateral sectionectomy in living donors: safety and reproducibility of the technique in a single center. Ann Surg 244:815PubMedCentralCrossRefPubMed
25.
Thenappan A, Jha RC, Fishbein T, Matsumoto C, Melancon JK, Girlanda R et al (2011) Liver allograft outcomes after laparoscopic-assisted and minimal access live donor hepatectomy for transplantation. Am J Surg 201:450–455CrossRefPubMed
26.
Choi H, You Y, Na G, Hong T, Shetty G, Kim D (2012) Single-port laparoscopy-assisted donor right hepatectomy in living donor liver transplantation: sensible approach or unnecessary hindrance? Transplant Proc 44:347–352CrossRefPubMed
27.
Marubashi S, Wada H, Kawamoto K, Kobayashi S, Eguchi H, Doki Y et al (2013) Laparoscopy-assisted hybrid left-side donor hepatectomy. World J Surg 37:2202–2210CrossRefPubMed
28.
West SL, King V, Carey TS, Lohr KN, McKoy N, Sutton SF et al. Systems to rate the strength of scientific evidence. Agency for Healthcare Research and Quality, US Department of Health and Human Services 2002
29.
Akoad M, Pomfret E (2013) Laparoscopic live donor hepatectomy: random mutation or stepwise evolution? Am J Transpl 13:2243–2244CrossRef
30.
Ha T, Hwang S, Ahn C, Kim K, Moon D, Song G et al (2013) Role of hand-assisted laparoscopic surgery in living-donor right liver harvest. Transplant Proc 45:2997–2999CrossRefPubMed
31.
Soubrane O, Perdigao Cotta F, Scatton O (2013) Pure laparoscopic right hepatectomy in a living donor. Am J Transplant 13:2467–2471CrossRefPubMed
32.
Samstein B, Cherqui D, Rotellar F, Griesemer A, Halazun K, Kato T et al (2013) Totally laparoscopic full left hepatectomy for living donor liver transplantation in adolescents and adults. Am J Transplant 13:2462–2466CrossRefPubMed
33.
Pinto PA, Montgomery RA, Ryan B, Roberts W, Hsu T, Kavoussi P et al (2003) Laparoscopic procurement model for living donor liver transplantation. Clin Transplant 17:39–43CrossRefPubMed
34.
Lei J, Yan L, Wang W (2013) Difference in outcomes between living left lobe donors and noncirrhotic subjects undergoing left lobe resections. Transplant Proc 45:2248–2252CrossRefPubMed
35.
Marubashi S, Wada H, Kawamoto K, Kobayashi S, Eguchi H, Doki Y et al (2014) Laparoscopy-assisted hybrid left-side donor hepatectomy: rationale for performing LADH. World J Surg 38:1562–1563CrossRefPubMed
36.
Suh K, Yi N, Kim J, Shin W, Lee H, Han H et al (2008) Laparoscopic hepatectomy for a modified right graft in adult-to-adult living donor liver transplantation. Transplant Proc 40:3529–3531CrossRefPubMed
37.
Scatton O, Katsanos G, Boillot O, Goumard C, Bernard D, Stenard F et al. (2014) Pure laparoscopic left lateral sectionectomy in living donors. Ann Surg (in press)
38.
Tzvetanov I, Bejarano-Pineda L, Giulianotti PC, Jeon H, Garcia-Roca R, Bianco F et al (2013) State of the art of robotic surgery in organ transplantation. World J Surg 37:2791–2799CrossRefPubMed
39.
Koffron A, Kung R, Baker T, Fryer J, Clark L, Abecassis M (2006) Laparoscopic-assisted right lobe donor hepatectomy. Am J Transplant 6:2522–2525CrossRefPubMed
40.
Gruttadauria S, Pagano D, Cintorino D, Arcadipane A, Traina M, Volpes R et al (2013) Right hepatic lobe living donation: a 12 years single Italian center experience. World J Gastroenterol 19:6353PubMedCentralCrossRefPubMed
41.
Kurosaki I, Yamamoto S, Kitami C, Yokoyama N, Nakatsuka H, Kobayashi T et al (2006) Video-assisted living donor hemihepatectomy through a 12-cm incision for adult-to-adult liver transplantation. Surgery 139:695–703CrossRefPubMed
42.
Guba M, Adcock L, MacLeod C, Cattral M, Greig P, Levy G et al (2010) Intraoperative “no go” donor hepatectomies in living donor liver transplantation. Am J Transplant 10:612–618CrossRefPubMed
43.
Rotellar F, Pardo F, Benito A, Marti-Cruchaga P, Zozaya G, Lopez L et al (2013) Totally laparoscopic right-lobe hepatectomy for adult living donor liver transplantation: useful strategies to enhance safety. Am J Transplant 13:3269–3273CrossRefPubMed
44.
Suh K-S, Yi N-J, Kim T, Kim J, Shin WY, Lee HW et al (2009) Laparoscopy-assisted donor right hepatectomy using a hand port system preserving the middle hepatic vein branches. World J Surg 33:526–533CrossRefPubMed
45.
Mulligan DC (2012) Living donor safety during the performance of hepatectomy. Liver Transplant 18:1134CrossRef
46.
Troisi R, Debruyne R, Rogiers X (2009) Laparoscopic living donor hepatectomy for pediatric liver transplantation. Acta Chir Belg 109:559–562PubMed
47.
Troisi RI, Van Huysse J, Berrevoet F, Vandenbossche B, Sainz-Barriga M, Vinci A et al (2011) Evolution of laparoscopic left lateral sectionectomy without the Pringle maneuver: through resection of benign and malignant tumors to living liver donation. Surg Endosc 25:79–87PubMedCentralCrossRefPubMed
48.
49.
Eguchi S, Takatsuki M, Soyama A, Hidaka M, Tomonaga T, Muraoka I et al (2011) Elective living donor liver transplantation by hybrid hand-assisted laparoscopic surgery and short upper midline laparotomy. Surgery 150:1002–1005CrossRefPubMed
50.
Kim SH, Cho SY, Lee KW, Park S-J, Han S-S (2009) Upper midline incision for living donor right hepatectomy. Liver Transplant 15:193–198CrossRef
51.
Schemmer P, Barro-Bejarano M, Mehrabi A, Gebhard M, Kraus T, Büchler M et al (2005) Laparoscopic organ retrieval for living donor liver transplantation does not prevent graft injury. Transplant Proc. 37:1625–1627CrossRefPubMed
52.
Ishizawa T, Hasegawa K, Kokudo N (2013) Laparoscopy-assisted hybrid left-side donor hepatectomy: is it truly less invasive for living donors? World J Surg 38:1–2
53.
Lin E, Gonzalez R, Venkatesh K, Mattar S, Bowers S, Fugate K et al (2003) Can current technology be integrated to facilitate laparoscopic living donor hepatectomy? Surg Endosc Other Interv Tech 17:750–753CrossRef
54.
Troisi R, Wojcicki M, Tomassini F, Houtmeyers P, Vanlander A, Berrevoet F et al (2013) Pure laparoscopic full-left living donor hepatectomy for calculated small-for-size LDLT in adults: proof of concept. Am J Transplant 13:2472–2478CrossRefPubMed
55.
Lee K-W, Kim SH, Han S-S, Kim Y-K, Cho SY, You T et al (2011) Use of an upper midline incision for living donor partial hepatectomy: a series of 143 consecutive cases. Liver Transplant 17:969–975CrossRef
56.
Soyama A, Takatsuki M, Hidaka M, Muraoka I, Tanaka T, Yamaguchi I et al (2012) Standardized less invasive living donor hemihepatectomy using the hybrid method through a short upper midline incision. Transplant Proc 44:353–355CrossRefPubMed
57.
Coelho JCU, de Freitas ACT, Mathias JEF (2009) Laparoscopic resection of the left lateral segment of the liver in living donor liver transplantation. Revista do Colégio Brasileiro de Cirurgiões 36:537–538CrossRefPubMed
58.
Cuomo O, Troisi R, Militerno G, Ragozzino A, De Rosa V, Di Florio E et al (2001) Living orthotopic liver transplant using right lobe: our experience in the first 19 donors. Transplant Proc 33:3801–3802CrossRefPubMed
59.
Lerut J, Gordon R, Iwatsuki S, Starzl T (1987) Surgical complications in human orthotopic liver transplantation. Acta Chir Belg 87:193PubMedCentralPubMed
60.
Wakabayashi G, Nitta H, Takahara T, Shimazu M, Kitajima M, Sasaki A (2009) Standardization of basic skills for laparoscopic liver surgery towards laparoscopic donor hepatectomy. J Hepatobiliary Pancreat Surg 16:439–444CrossRefPubMed
61.
Kaneko H, Tsuchiya M, Otsuka Y, Yajima S, Minagawa T, Watanabe M et al (2009) Laparoscopic hepatectomy for hepatocellular carcinoma in cirrhotic patients. J Hepatobiliary Pancreat Surg 16:433–438CrossRefPubMed
62.
Wei M, He Y, Wang J, Chen N, Zhou Z, Wang Z (2014) Laparoscopic versus open hepatectomy with or without synchronous colectomy for colorectal liver metastasis: a meta-analysis. PLoS One 9:e87461PubMedCentralCrossRefPubMed
63.
Trotter JF, Adam R, Lo CM, Kenison J (2006) Documented deaths of hepatic lobe donors for living donor liver transplantation. Liver Transplant 12:1485–1488CrossRef
64.
Kowalczyk L (2010) At the Lahey, a stunning, rare tragedy: donor dies in liver transplant attempt. Boston Globe
Metadaten
Titel
Donor safety in live donor laparoscopic liver procurement: systematic review and meta-analysis
verfasst von
Mohamed Bekheit
Philipe-Abrahim Khafagy
Petru Bucur
Khaled Katri
Ahmed Elgendi
Wael Nabil Abdel-salam
Eric Vibert
El-said El-kayal
Publikationsdatum
01.11.2015
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 11/2015
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-014-4045-1

Weitere Artikel der Ausgabe 11/2015

Surgical Endoscopy 11/2015 Zur Ausgabe

OriginalPaper

Minimal invasive surgery: NOSE and NOTES in ulcerative colitis

New Technology

Modified laparoscopic hepatectomy for hepatic hemangioma

Erratum

Erratum to: OpenHELP (Heidelberg laparoscopy phantom): development of an open-source surgical evaluation and training tool

New Technology

Comparison of electrical current and ultrasonic device for incision of the septum of the pharyngoesophageal diverticulum in a pig model

OriginalPaper

No difference in incidence of port-site hernia and chronic pain after single-incision laparoscopic cholecystectomy versus conventional laparoscopic cholecystectomy: a nationwide prospective, matched cohort study

Dynamic Manuscript

Surgical outcomes of intracorporeal circular-stapled esophagojejunostomy using modified over-and-over suture technique in laparoscopic total gastrectomy

Neu im Fachgebiet Chirurgie

19.04.2024 | EAU 2024 | Kongressbericht | Nachrichten

Ureterstriktur: Innovative OP-Technik bewährt sich

17.04.2024 | Postoperative nausea and vomiting | Nachrichten

Hochrisiko-Eingriffe für postoperative Übelkeit

16.04.2024 | HNO-Chirurgie | Nachrichten

HNO-Op. auch mit über 90?

16.04.2024 | DGIM 2024 | Nachrichten

Kein Abstrich bei chronischen Wunden ohne Entzündungszeichen!
weitere anzeigen

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom CME-Kurs
CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur CME-Kurs
CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis CME-Kurs
CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.