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Olivier Giannini

Publications and source records attributed to Olivier Giannini.

6 recordsLinked to original sources
PubMed2006

How painful is donor nephrectomy? Retrospective analysis of early pain and pain management in open versus laparoscopic versus retroperitoneoscopic nephrectomy.

BACKGROUND: The aim of this study was to evaluate the early postoperative pain and pain management after standard open (ODN), hand-assisted laparoscopic (HLDN) and retroperitoneoscopic (RDN) donor nephrectomy. METHODS: The visual analogue scale (VAS) was determined twice a day in 203 donors during the first five days after nephrectomy. RESULTS: Mean VAS was significantly lower after RDN and HLDN than after ODN on day 2 (p=0.004) and days 3-5 (p<0.001). After RDN, "no pain" (VAS=0) was reported significantly earlier than after ODN. Irrespective of the technique used and the pain management, all donors reported significantly higher VAS in the morning. Opiates were administered for a significantly shorter average time period after RDN than after ODN (p=0.005). Cumulative morphine equivalent doses were higher after ODN than after RDN (p=0.001). Mean VAS reported after HLDN and RDN was similar. CONCLUSIONS: In summary, RDN and HLDN were clearly associated with much less early pain than ODN, independently of the used pain management.

Adult↗
PubMed2005

Retroperitoneoscopic donor nephrectomy: a retrospective, non-randomized comparison of early complications, donor and recipient outcome with the standard open approach.

OBJECTIVES: We retrospectively performed a comparative analysis of retroperitoneoscopic and open donor nephrectomy in terms of donor complications, as well as recipient complications and functional graft outcome. METHODS: A total of 134 donor nephrectomies including 69 open (ODN) and 65 retroperitoneoscopic (RDN) nephrectomies was analyzed retrospectively. Both groups were comparable in terms of age, body mass index (BMI), operating time (OPT), warm ischemia time (WIT) and blood loss. RESULTS: There were no statistically significant differences with respect to recipient outcome, mean values for age, BMI, OPT and cold ischemia time (CIT). The overall donor complication rate did not differ. Early functional graft follow-up showed significant differences in 24 h-urine output between the two groups (p<0.001), but serum creatinine was comparable after 7, 30, 180 and 365 days. The early rejection rate in the recipients was similar in the two groups. CONCLUSION: Retroperitoneoscopic donor nephrectomy (RDN) provides comparable perioperative features, such as operating time, warm ischemia time (WIT) and overall complication rate to the open donor nephrectomy (ODN). Additionally, it has no negative impact on recipients' operating time, graft ischemia and early graft function.

Adult↗
PubMed2005

Chyloretroperitoneum with secondary chylothorax after retroperitoneoscopic donor nephrectomy.

A 59-year-old woman complained of increasing pain in the left abdomen and of diarrheal symptoms after left-sided retroperitoneoscopic living donor nephrectomy. Computed tomography revealed chyloretroperitoneum. The fluid was drained percutaneously, followed by recurrent drain replacement surgery. Her diet was changed to short-chain and medium-chain fatty acids without success. After onset of dyspnea due to chylothorax, the donor underwent thoracic drainage, fully parenteral therapy, and finally somatostatin application therapy. The postoperative management of severe chylous fistula is difficult. Therefore, we recommend an early start of maximal conservative therapy. Surgical options depend on pain occurrence or mechanical problems.

Chylothorax↗
PubMed2004

Retroperitoneoscopic living donor nephrectomy: a retrospective comparison to the open approach.

A purely retroperitoneoscopic approach in living kidney donation is used by only a few centers worldwide. Data from 28 consecutive purely retroperitoneoscopic living donor nephrectomies (RLDN) were compared to the most recent 30 open living donor nephrectomies (OLDN). Right-sided donation was performed in 12 cases (43%) of the RLDN and 11 cases (37%) of the OLDN. Comparison of the results between the two groups showed a shorter operation time and hospital stay for the RLDN group (P < 0.001). Warm ischemia time was significantly shorter in the OLDN group (P < 0.02). The rate of complications did not differ significantly between the groups. No significant difference in terms of renal graft function was detected within 30 days after surgery. As a result of the direct access, RLDN is superior in terms of operation time, even to the open access on our series, while maintaining the advantage of minimal invasiveness.

Adolescent↗
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