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    Comparison of Open and Retroperitonoscopic Donor Nephrectomy in Terms of Lipid and Protein Peroxidation Responses
    (ELSEVIER SCIENCE INC, 2013) Dinckan, A.; Dinc, B.; Turkyilmaz, S.; Tekin, A.; Kocak, H.; Akbas, H.; Mesci, A.
    Background. This study was designed to compare donors who underwent open (ODN) versus retroperitonoscopic nephrectomy (RDN) in terms of intra-operative oxidative stress and recipients graft function in the early postoperative period. Methods. Among 40 patients who underwent donor nephrectomy, 23 were operated via an open method and 17 via retroperitonoscopic method. To analyze oxidative stress, we measured plasma levels of malondialdehyde (MDA), protein carbonyl, and protein sulfhydryl moieties in donor venous blood before induction of anesthesia and postoperatively at 0, 6, and 24 hours. The influence of oxidative stress on graft function was evaluated by means of the postoperative 5th day recipient creatinine and estimated glomerular filtration rate (eGFR) Modification of Diet in Renal Disease Formula (MDRD) to evaluate delayed graft function (DGF) status. Results. ODN patients showed significantly higher 24-hour mean levels of MDA, (6,139 +/- 1,854 vs 4,813 +/- 1,771 nmol/L; P =.01), protein carbonyl (366 +/- 64 vs 311 +/- 62 innol/L; P =.01) and protein sulfhydryl (468 +/- 110 vs 386 +/- 75 umol/L; P =.01) moieties compared with those RDN patients. However, ODN and RDN recipients were similar in terms of 5th day mean creatinine and eGFR (1.1 +/- 0.3 vs 1.4 +/- 0.8 mg/dL and 69.15 +/- 12.24 vs 56.31 +/- 25.2, respectively) and DGF status (4.4% [1/23] vs 5.9% [1/17], respectively). Conclusions. Although ODN donors were more prone to intra-operative oxidative stress than RDN donors, based on significantly higher levels of oxidative stress markers, this difference seems to not significantly influence recipients early graft function.
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    Evaluation of laparoscopic transperitoneal adrenalectomy: is it feasible for large masses?
    (EDIZIONI MINERVA MEDICA, 2015) Mesci, A.; Celik, O.; Akand, M.; Aydogdu, O.; Arici, G.; Arici, C.; Erdogru, T.
    Aim. The aim of this paper was to determine whether laparoscopic adrenalectomy (LA) is a safe and effective treatment for the management of large adrenal tumors. Methods. We retrospectively evaluated the data of patients who underwent LA at our institution between September 2002 and September 2012. Seventy-six transperitoneal LA were performed by the same surgical team. Patients with invasive tumors to adjacent organs or distant metastasis were excluded from the study. All patients were operated using the 450 oblique position as transperitoneal approach. Results. The mean age of the patients was 48.3 years (range 20-68 years). The mean tumor size was 5.37 cm (range 2-15 cm). Sixteen patients had tumor size over 8 cm. The mean tumor weight was 31.2 gr (range 2-156 g). The lesions were localized on the tight side in 42 (55%) patients and on the left side in 34 (45%) patients. The mean intraoperative blood loss was 114 mL (range 20-400 mL) and the mean operative time was 112 min (range 55-300 min). Six patients (7%) required conversion to open procedure. The mean hospitalization time was 2.5 days (range 1-4 days). Five patients (6%) had postoperative minor complications. There were no incidents of capsular invasion or adverse cardiovascular events. Conclusion. LA is safe and feasible for both malign and benign adrenal lesions. Good preoperative assessment, surgical skills, team work and adherence to anatomical and surgical principles are the key to success for large adrenal masses.