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Biomedical subjects

A Tabibi

Publications and source records attributed to A Tabibi.

9 recordsLinked to original sources
PubMed2006

Pedicular vascular control in laparoscopic living donor nephrectomy: The use of clips instead of stapler in 341 donors.

PURPOSE: To demonstrate a less expensive approach for laparoscopic donor nephrectomy. MATERIALS AND METHODS: Left donor nephrectomy was done transperitoneally in flank position. Renal vein and artery were exposed and prepared for nephrectomy. Nondisposable trocars and instruments were used. The adrenal vein was clipped and its arteries were bipolar coagulated. Both renal artery and vein were clip-ligated using three medium large nonautomatic metallic clips and divided, instead of using rather expensive vascular endostapler. Kidney was hand-extracted from suprapubic incision (no Endobag was used). RESULTS: Donor nephrectomy was performed in 341 donors. Mean warm ischemia time was 8.17 minutes. Mean operative time was 260.3 minutes. Conversion and reoperation was required in 2.1% and 3.8% of donors, respectively. Ureteral complications were observed in 2.1% of recipients. No vascular accident occurred from pedicular vessels. One-year graft survival in recipients was 92.6%. By this approach, at least $600 was saved in each nephrectomy. CONCLUSION: Laparoscopic donor nephrectomy can be performed with a less expensive setup without adverse effects on graft outcome. Vascular control using nonautomatic clips instead of more costly vascular endostapler and also hand extraction of the kidney is safe, practical, and economical.

Follow-Up Studies↗
PubMed2006

Laparoscopic pyelopyelostomy for retrocaval ureter without excision of the retrocaval segment: first report of 6 cases.

PURPOSE: We report our series of 6 cases of retrocaval ureter that were successfully treated with a laparoscopic approach. MATERIALS AND METHODS: Three men and 3 women with a mean age of 31 years (range 16 to 50) were referred to our department with a diagnosis of retrocaval ureter. One patient had a 12 mm renal pelvic calculus. A transperitoneal laparoscopic approach was used in all cases. The retrocaval segment along with some of the more proximal and distal segments of the ureter was readily mobilized. The distal part of the dilated renal pelvis was transected and the divided distal segment was repositioned to lie anterior to the inferior vena cava. The renal pelvic stone in 1 patient was readily removed at this point. Re-anastomosis was then performed over a Double-J stent placed intraoperatively using 2 rows of running 4-zero polyglactin sutures with intracorporeal knot tying. The stent was removed 4 weeks later. Excretory urography was performed 3 months after the laparoscopic procedure. RESULTS: Mean operative duration was 180 minutes (range 150 to 210). Patients were discharged home at a mean of 4 days (range 3 to 5). Followup excretory urogram 3 months after laparoscopic repair revealed a widely patent anastomosis with considerable improvement in hydronephrosis in all patients. CONCLUSIONS: To our knowledge this is the largest series of laparoscopic repair of retrocaval ureter reported to date. Laparoscopic pyelopyelostomy for retrocaval ureter without excision of the retrocaval segment is associated with an excellent outcome, minimal postoperative morbidity, short hospital stay and highly satisfactory cosmetic results.

Adolescent↗
PubMed2006

Effect of warm ischemia on graft outcome in laparoscopic donor nephrectomy.

PURPOSE: To assess the impact of warm ischemia time (WIT) on delayed graft function (DGF), graft loss, and graft function in laparoscopic donor nephrectomy (LDN). PATIENTS AND METHODS: We prospectively studied 100 kidney recipients from LDN donors from 2001 to 2003. For comparison of graft outcome with different extents of WIT, recipients were divided into three groups: group A received kidneys having 4 to 6 minutes, group B kidneys having >6 to 10 minutes, and group C kidneys having >10 minutes of WIT. The median follow-up was 415 days (range 11-791) days. RESULTS: The mean kidney WIT was 8.7 minutes (range 4-17 minutes). Graft outcome (DGF, graft loss, and median serum creatinine) was not significantly different in the three groups. CONCLUSIONS: Different extents of WIT in LDN, within the range of our study, were not associated with an adverse outcome in kidney transplantation.

Adolescent↗
PubMed2005

Concomitant nephrectomy of massively enlarged kidneys and renal transplantation in autosomal dominant polycystic kidney disease.

OBJECTIVES: We compared perioperative and intraoperative data of patients with end-stage renal disease (ESRD) due to autosomal dominant polycystic kidney disease (ADPKD) who received a renal allograft without native nephrectomy with ADPKD patients who underwent concomitant native nephrectomy of massively enlarged kidneys and renal transplantation to determine whether the latter approach is reasonable and safe. PATIENTS AND METHODS: From January 1987 to December 2003, 13 patients with ESRD due to ADPKD were stratified as 6 patients who underwent bilateral and 7 patients who underwent unilateral native nephrectomy in conjunction with renal transplantation (group A), versus 20 patients with ESRD due to ADPKD underwent renal transplantation without native nephrectomy (group B). Operative time, need for intraoperative transfusion, time to oral intake, duration of hospital stay, serum creatinine level on the day of discharge, readmission rate, and postoperative complications were compared for both groups. RESULTS: Mean intraoperative duration was significantly longer for patients in group A, but there was no statistically significant difference in the findings between both groups. CONCLUSIONS: Concomitant native nephrectomy of massively enlarged kidneys at the time of renal transplantation is reasonable and safe for patients with ESRD due to ADPKD.

Adult↗
PubMed2005

Laparoscopic management of ureteropelvic junction obstruction by division of anterior crossing vein and cephalad relocation of anterior crossing artery.

PURPOSE: We report our experience with laparoscopic management of ureteropelvic junction (UPJ) obstruction by division of the anterior crossing vein and cephalad relocation of the anterior crossing artery. PATIENTS AND METHODS: We used this laparoscopic approach in four male and six female patients with UPJ obstruction associated with anterior crossing vessels. The mean age of the patients was 31.9 years (range 14-59 years). The obstruction was present on the right side in four and on the left side in six patients. Using a transperitoneal approach, the crossing vein was divided, while the crossing artery was preserved, relocated cephalad, and fixed to the peripelvic tissues with metal clips or sutures. Because a grossly normal appearance of the UPJ and upper ureter together with proper pyeloureteral peristalsis and complete renal pelvic emptying were observed intraoperatively, dismembered pyeloplasty was not performed in any of these patients. Diuretic renography and intravenous urography were performed 3, 6, and 12 months postoperatively. RESULTS: The mean operative duration was 140 minutes (range 100-170 minutes). The mean hospital stay was 2.9 days (range 2-5 days), and the mean follow-up was 9.1 months (range 3-22 months). Diuretic renography revealed absence of obstruction in all patients, and intravenous urography showed considerable improvement of the hydronephrosis. CONCLUSION: Select cases of UPJ obstruction associated with anterior crossing vessels seem to be amenable to laparoscopic management by division of the crossing vein and cephalad relocation of the crossing artery. Laparoscopy as a minimally invasive approach may offer a better opportunity to evaluate the role of anterior crossing vessels in UPJ obstruction.

Adolescent↗
PubMed1982

A comparison of methods used in root canal sealability studies.

The purpose of the study was to compare several methods that have been used to assess marginal leakage of root canal fillings. Sixty-three extracted, single-rooted teeth were instrumented and filled in a standardized manner. Teeth were randomly divided into groups of twenty and exposed to solutions containing methylene blue dye, calcium-45, carbon-14-labeled urea, and iodine-125-labeled albumin for 48 hours to compare the degree of leakage indicated by each technique. Methylene blue dye was found to penetrate farther up the canal than any of the isotope tracers. Carbon-14-labeled urea penetrated farther than the calcium-45- or iodine-125-labeled albumin. The mean volume of solution penetrating the teeth was exceedingly small (0.0011 ml) and probably unimportant physiologically.

Calcium Radioisotopes↗
PubMed1978

A comparative sealability study of different retrofilling materials.

The purpose of the study was to compare the sealing properties of Cavit and zinc polycarboxylate cement with silver amalgam when used as retrofilling materials of root canals. The retrofilling materials were placed at the apices of dogs' teeth and were left there for a 6-month period, after which time the teeth were extracted and the marginal leakage was evaluated by C14-labeled urea. A second part of the study included an in vitro placement of the retrofillings. Previously extracted teeth were used and the same retrofilling materials were placed. They were left to set for 2 days in physiologic saline solution. Then the same evaluation for leakage was used. The purpose of the second part was to compare and evaluate the effect of aging on sealability. Under the conditions of this study, amalgam afforded a better seal in the 6-month group than polycarboxylate cement or Cavit. Both Cavit and polycarboxylate cement showed more leakage in the 6-month group. The deterioration of the seal afforded by Cavit in the 6-month group was statistically significant. The seal of amalgam was the only one which was improved by time.

Acrylic Resins↗