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- 저자 : ( Yerlan-sultangereyev ) (검색결과 3 건)
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The First Case of Pure 3D Laparoscopic Living Donor Hepatectomy in Kazakhstan
( Kyung Chul Yoon ),( Kaliev Aset ),( Zhanadil Almyrzauly ),( Yerlan-sultangereyev ),( Bazylbek Zhakiev ),( Kwang-woong Lee ),( Kyung Chul Yoon ),( Kaliev Aset ),( Zhanadil Almyrzauly ),( Bazylbek Zha 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: Laparoscopic living donor hepatectomy is performed selectively in some countries because of the small sized structures and anatomic variations which requires more precise technique. In Kazakhstan about 200 cases of living donor liver transplantation were performed starting from December 2011.We now present the first case of laparoscopic living donor hepatectomy in Kazakhstan using a 3D laparoscopic device with colleagues from Seoul National University Hospital, Korea by professor KwangWoong Lee. Methods: A 23-year-old male volunteered for living donor to his older brother who had combined hepatitis B, D and C related cirrhosis without any history of antiviral treatment. The recipient age was 36 and His model for end-stage liver disease score was 22. Brief morphologic characteristics of donor and recipient were as follows: donor - height 177 cm, weight 74 kg, BMI 23.64 kg/m<sup>2</sup>standard liver volume 1348 ml; recipient - height 172 cm, weight 78 kg, BMI 26.44 kg/m<sup>2</sup>, standard liver volume 1350ml.Donor graft volume was 820ml and left remnant liver volume was 32%. Results: The surgery was performed in October 2016 with 5 port insertion using an ultrasonic dissector, Cabitron Ultrasonic Aspirator, and clips. The liver was extracted via 10 cm sized suprapubic incision. V5 and V8 were reconstructed to the right hepatic vein using the PTFE graft. The Donor’s operation time was 295 minutes and estimated bleeding was 700ml. The recipient had sanguinous drain and bleeding control was performed postoperative day 1 due to bleeding from hilar plate. Both donor and recipient were discharged after 15 and 28 days and the donor was not eventful. Conclusions: 3D laparoscopic hepatectomy has been progressively developed along the past decade. High quality studies allied with high-level surgical training are required to base surgical practice and to disseminate the benefits of to many centers as possible. Future applicability of new technologies such as robot assistance and 3D surgery is still under investigation in Kazakhstan.
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Retrograde reperfusion of renal grafts to reduce ischemic-reperfusion injury
Myltykbay Rysmakhanov,Aibolat Smagulov,Nadiar Mussin,Asset Kaliyev,Bazylbek Zhakiyev,Yerlan Sultangereyev,Gani Kuttymuratov 대한이식학회 2022 Korean Journal of Transplantation Vol.36 No.4
Background: During transplantation, a kidney graft undergoes a cascade of pathological changes, referred to as ischemia-reperfusion injury (IRI), as it is incorporated into the bloodstream. Various studies have reported that retrograde reperfusion (RRP) leads to improved myocardial recovery and could reduce IRI in liver transplantation. This study investigated the effect of RRP in renal transplantation with a focus on reduction of kidney IRI. Methods: Between December 2019 and July 2022, 15 consecutive kidney transplants were performed with retrograde venous reperfusion. To conduct a comparative study and to recruit a control group, 15 kidney transplants that had been performed in the same center by the same two surgeons were retrospectively analyzed. Differences between the two groups were considered statistically significant at P<0.05. Results: The baseline characteristics of the two groups were statistically comparable (P>0.05). The surgical technique for kidney transplantation was the same in both groups. On the first postoperative day, polyuria was less pronounced in the RRP group (P<0.01). Serum creatinine and urea levels and estimated glomerular filtration rates on postoperative days 1, 4, 7, and 30 were lower in the RRP group (P<0.05). Conclusions: Retrograde venous reperfusion of a kidney transplant, preceding antegrade arterial reperfusion, reduced the effects of renal parenchyma IRI. To validate the results of this study, it is necessary to conduct further studies on a larger cohort of patients with a longer follow-up period.
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Myltykbay Rysmakhanov,Asset Yelemessov,Nadiar Mussin,Daulet Yessenbayev,Samat Saparbayev,Bazylbek Zhakiyev,Yerlan Sultangereyev 대한이식학회 2022 Korean Journal of Transplantation Vol.36 No.2
Background: This is the first report on three-dimensional (3D) laparoscopic donor nephrectomy performed in the Central Asian region and Commonwealth of Indepen- dent States countries. This study presents the results of our initial experiences of 3D hand-assisted laparoscopic donor nephrectomy (3D-HALDN) in comparison with the outcomes of two-dimensional hand-assisted laparoscopic donor nephrectomy (2D-HALDN) at a single center. Methods: From 2015 to 2019, 19 3D-HALDN and 19 2D-HALDN procedures were per- formed at the same center by two surgeons. All 38 procedures used identical tech- niques. Between-group differences were considered statistically significant at P<0.05. Results: The baseline characteristics in both groups were statistically comparable (P>0.05). All donors underwent left nephrectomy. Donors who underwent 3D-HALDN had better outcomes than those who underwent 2D-HALDN, as shown by a shorter warm ischemic time (P<0.05), a shorter operative time (P<0.05), and less blood loss (P<0.05). There were no conversions or major complications (according to the Clavien-Dindo classification) in either group. The average drainage duration and postoperative hospital- ization were significantly shorter in the 3D-HALDN group (P<0.05). The between-group differences in the mean postoperative creatinine level and glomerular filtration rate were not significant. Conclusions: The 3D-HALDN approach is more beneficial than traditional 2D-HALDN by providing a shorter warm ischemic time, less blood loss, and shorter durations of drain- age and postoperative hospitalization. Postoperative complications and the functional condition of the kidney in donors in the early and late postoperative periods did not de- pend on the type of laparoscopic donor nephrectomy.
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