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Paper Information

Title: 

"FREQUENCY AND MANAGEMENT OF PNEUMOTHORAX AFTER LIVING DONOR NEPHRECTOMY IN GOLLEASTAN HOSPITAL"

Type: PAPER
Author(s): JAVADNEIA ABDULHOSSEIN*,TAEE KARIM,SAKHAEE SHAHROKH,OSTADIAN FARZAD
 
 *
 
Name of Seminar: CONGREH ANJOMAN UROLOGY IRAN
Type of Seminar:  CONGRESS
Sponsor:  ANJOMAN OROLOGY
Date:  2005Volume 8
 
 
Abstract: 

PROPOSE: IN THIS STUDY WE ASSESSED FREQUENCY AND MANAGEMENT OF PNEUMOTHORAX, WHICH IS A COMMON IATROGENIC COMPLICATION IN LIVING DONOR NEPHRECTOMY.
METHODS & MATERIALS: FROM 1990 TO 2002, 360 LIVING DONORS (MEAN AGE 24.5 YEARS, RANGED 18-54) WITH RATIO OF WOMEN TO MEN 2/3 UNDERWENT NEPHRECTOMY VIA FLANK INCISION (EXTRAPRITONEAL AND RETROPLEURAL). THE RATIO OF LEFT NEPHRECTOMY TO RIGHT WAS 3/1. RIB RESECTION WAS DONE IN 166 CASES (46%), (LEFT 59% AND RIGHT 41%). IN 76 PATIENTS (21%) PLEURAL CAVITY WAS ENTERED (76% LEFT AND 24% RIGHT). THE OPENING LENGTH WAS 4-75 MM (MEAN 32 MM). PLEURA WAS CLOSED IMMEDIATELY IN ALL CASES AND CONTROL CHEST X-RAY WAS TAKEN AT RECOVERY ROOM.
RESULTS: MILD PNEUMOTHORAX (<10%) OCCURRED IN 4 CASES (1.1%) WITH ASSOCIATED SYMPTOMS DYSPNEA AND MILD PLEURETIC PAIN. ALL PATIENTS MANAGED CONSERVATIVELY WITHOUT CHEST TUBE. PLEURAL INJURY RATES 27% AND 5% RESPECTIVELY WITH AND WITHOUT RIB RESECTION WERE OBTAINED THAT STATICALLY DIFFERENCE WAS SIGNIFICANT (P<0.001).
DISCUSSION & CONCLUSION: IF PLEURAL INJURIES REPAIRED CAREFULLY, PNEUMOTHORAX WILL NOT BE COMMON. IN CASES OF SIGNIFICANT PNEUMOTHORAX, PATIENTS MANIFEST RESPIRATORY SYMPTOMS, SO CHEST X-RAY ISN’T NECESSARY ROUTINELY. IF PLEURAL INJURIES RECOGNIZED INTRAOPERATIVELY, INSERTION OF CHEST TUBE ISN’T NECESSARY ROUTINELY. ALSO POSSIBILITY OF PLEURAL INJURIES INCREASES WITH RIB RESECTION.

 
Keyword(s): PNEUMOTHORAX, LIVING DONOR NEPHRECTOMY, CHEST TUBE, CHEST X-RAY, RIB RESECTION
 
 
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