Mini-laparoscopic live donor nephrectomy with the use of 3-mm instruments and laparoscope

PURPOSE

To analyze our preliminary outcomes on the use of 3 mm instruments for laparoscopic live donor nephrectomy (LLDN).

METHODS

Our series includes thirteen patients, who underwent LLDN using 3-mm instruments and laparoscope and 5-mm transumbilical trocar. The patients were followed at 7 and 14 days from discharge and were specifically asked about their cosmetic satisfaction. At follow-up, the recipient graft function was controlled, as well as the donor's cosmetic results. Eight months after surgery, all thirteen patients were asked to fill out the Patient Scar Assessment Questionnaire and Scoring System (PSAQ).

RESULTS

All patients presented good recovery after surgery. Regarding cosmetic outcomes, the donors expressed their satisfaction toward the minimal incision size and optimal esthetic results at 7 and 14 days from discharge home. The low scores on each section of the PSAQ confirmed the favorable outcomes. Early graft function was satisfactory at 1 and 3 months after the kidney transplantation. Furthermore, there were no major complications in the recipients.

CONCLUSIONS

Our persistent positive results with the use of 3-mm instruments during LLDN support this technique as a good alternative to the standard laparoscopic approach for minimizing the incision site, while maintaining safety and excellent clinical outcomes. The fact that the general laparoscopic standards are maintained could make this approach a very attractive alternative to the other minimally invasive approaches for live donor nephrectomy. The hope is in that the higher degree of satisfaction in the donor population demonstrated in this study may likely enhance living kidney donation.

Quality of life in prostate cancer patients and controls: psychometric validation of the FACTP-4 in Spanish, and relation to urinary symptoms

OBJECTIVES

To assess the feasibility and a validity of the Spanish version of the FACT-P and its relation to urinary symptoms.

METHODS

The Spanish version of the FACT-P was self-administered to 60 Prostate Cancer patients (pts) waiting to undergo radical treatment and 20 age-matched controls (con) with a negative biopsy. Clinical stage for patients was T1c in 34 and T2 in 26. FACT-P was analysed for internal consistency (Chronbach's a) and relation to symptom scales (IPSS, IPSS bother score and incontinence questionnaire (ICI-SF)).

RESULTS

Feasibility (evaluable questionnaires) was 80.9 for con and 95% for pts. Internal consistency was high for all sub-scales (alpha > 0.7). Emotional well-being subscale and IPSS were significantly higher in pts. (worse emotional wellbeing and more lower urinary tract symptoms). There were no statistically significant differences between pts and con. in any of the other FACT-P sub-scores nor in symptom scores. Correlations were found between some FACT-P sub-scores and bother score.

CONCLUSIONS

The Spanish version of the FACTP is feasible and psychometrically valid. Pts undergoing treatment for localized disease have similar QoL that a control group, but higher scores for emotional distress and IPSS.