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10.1371/journal.pone.0121131 http://scihub22266oqcxt.onion/10.1371/journal.pone.0121131 C4376908!4376908 !25816148     free     free     free Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=25816148 &cmd=llinks): Failed to open stream: HTTP request failed! 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A comparison of technique modifications in laparoscopic donor nephrectomy: a systematic review and meta-analysis |pdf=|usr=}}{{25816148 }} gab.com Text A comparison of technique modifications in laparoscopic donor nephrectomy: a systematic review and meta-analysis JO: PLoS One http://www.kidney.de/pget.php?&tw=1&pmid=25816148 #FOAvip OBJECTIVE: To compare the effectiveness of different technique modifications in laparoscopic donor nephrectomy. DESIGN: Systematic review and meta-analyses. DATA SOURCES: Searches of PubMed, EMBASE, Web of Science and Central from January 1st 1997 until April 1st 2014. STUDY DESIGN: All cohort studies and randomized clinical trials comparing fully laparoscopic donor nephrectomy with modifications of the standard technique including hand-assisted, retroperitoneoscopic and single port techniques, were included. DATA-EXTRACTION AND ANALYSIS: The primary outcome measure was the number of complications. Secondary outcome measures included: conversion to open surgery, first warm ischemia time, estimated blood loss, graft function, operation time and length of hospital stay. Each technique modification was compared with standard laparoscopic donor nephrectomy. Data was pooled with a random effects meta-analysis using odds ratios, weighted mean differences and their corresponding 95% confidence intervals. To assess heterogeneity, the I2 statistic was used. First, randomized clinical trials and cohort studies were analyzed separately, when data was comparable, pooled analysis were performed. RESULTS: 31 studies comparing laparoscopic donor nephrectomy with other technique modifications were identified, including 5 randomized clinical trials and 26 cohort studies. Since data of randomized clinical trials and cohort studies were comparable, these data were pooled. There were significantly less complications in the retroperitoneoscopic group as compared to transperitoneal group (OR 0.52, 95%CI 0.33-0.83, I2 = 0%). Hand-assisted techniques showed shorter first warm ischemia and operation times. CONCLUSIONS: Hand-assistance reduces the operation and first warm ischemia times and may improve safety for surgeons with less experience in laparoscopic donor nephrectomy. The retroperitoneoscopic approach was significantly associated with less complications. However, given the, in general, poor to intermediate quality and considerable heterogeneity in the included studies, further high-quality studies are required. TRIAL REGISTRATION: The review protocol was registered in the PROSPERO database before the start of the review process (CRD number 42013006565). Twit Text FOAVip A comparison of technique modifications in laparoscopic donor nephrectomy: a systematic review and meta-analysis ????PLoS One http://www.kidney.de/pget.php?&tw=1&pmid=25816148 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=25816148 #FOAvip English Wikipedia <ref>{{Cite pmid|25816148 }}</ref> A comparison of technique modifications in laparoscopic donor nephrectomy: a systematic review and meta-analysis #MMPMID25816148 Özdemir-van Brunschot DM ; Koning GG ; van Laarhoven KC ; Ergün M ; van Horne SB ; Rovers MM ; Warlé MC PLoS One 2015[]; 10 (3 ): e0121131 PMID25816148 show ga OBJECTIVE: To compare the effectiveness of different technique modifications in laparoscopic donor nephrectomy. DESIGN: Systematic review and meta-analyses. DATA SOURCES: Searches of PubMed, EMBASE, Web of Science and Central from January 1st 1997 until April 1st 2014. STUDY DESIGN: All cohort studies and randomized clinical trials comparing fully laparoscopic donor nephrectomy with modifications of the standard technique including hand-assisted, retroperitoneoscopic and single port techniques, were included. DATA-EXTRACTION AND ANALYSIS: The primary outcome measure was the number of complications. Secondary outcome measures included: conversion to open surgery, first warm ischemia time, estimated blood loss, graft function, operation time and length of hospital stay. Each technique modification was compared with standard laparoscopic donor nephrectomy. Data was pooled with a random effects meta-analysis using odds ratios, weighted mean differences and their corresponding 95% confidence intervals. To assess heterogeneity, the I2 statistic was used. First, randomized clinical trials and cohort studies were analyzed separately, when data was comparable, pooled analysis were performed. RESULTS: 31 studies comparing laparoscopic donor nephrectomy with other technique modifications were identified, including 5 randomized clinical trials and 26 cohort studies. Since data of randomized clinical trials and cohort studies were comparable, these data were pooled. There were significantly less complications in the retroperitoneoscopic group as compared to transperitoneal group (OR 0.52, 95%CI 0.33-0.83, I2 = 0%). Hand-assisted techniques showed shorter first warm ischemia and operation times. CONCLUSIONS: Hand-assistance reduces the operation and first warm ischemia times and may improve safety for surgeons with less experience in laparoscopic donor nephrectomy. The retroperitoneoscopic approach was significantly associated with less complications. However, given the, in general, poor to intermediate quality and considerable heterogeneity in the included studies, further high-quality studies are required. TRIAL REGISTRATION: The review protocol was registered in the PROSPERO database before the start of the review process (CRD number 42013006565). |Humans [MESH] |Kidney Transplantation [MESH] |Laparoscopy/instrumentation/*methods [MESH] |Living Donors [MESH] |Nephrectomy/adverse effects/instrumentation/*methods [MESH] |Postoperative Complications/etiology [MESH]A comparison of technique modifications in laparoscopic donor nephrect(epmc).pdf DeepDyve Pubget Overpricing