Two- and three-dimensional laparoscopic donor nephrectomy: a comparative study of a single-center experience

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.

Early complications of laparoscopic cholecystectomy

Myltykbay RYSMAKHANOV,Bazylbek ZHAKIYEV 한국간담췌외과학회 2021 Annals of hepato-biliary-pancreatic surgery Vol.25 No.-

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.

Early Complications of Laparoscopic Cholecystectomy

( Myltykbay Rysmakhanov ),( Bazylbek Zhakiyev ) 대한간학회 2021 춘·추계 학술대회 (KASL) Vol.2021 No.1

First Expiriens of Living Donor Liver Transplantation

( Zhanadil Almyrzauly ),( Myltykbay Rysmakhanov ),( Yerlansul-tangereev ),( Bazylbek Zhakiev ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

Aims: Presents to analyze of first experience of Living Donor LiverTransplantation (LDLT) at Aktobe Medical Center, in the two-year period. LDLT were performed with the participation of specialists from Korea. Methods: LDLT were done after the candidates (living donor and recipient) were : valuated following our practices guidelines. After donor right hepatectomies TNK solution with heparine was used for graft perfusion. “Middle hepatic vein” reconstruction performed by synthetic vascular graft. During recipient hepatectomy used “High Hillary Dissection” method. Right liver graft implantation made as standard technique. Before portal reperfusion, liver graft washed by 5% Albumine solution. Immunosupressive therapy in all patients included three components (CNI + MMF + Steroid) with introduction of Basiliximab (first and fourth postoperative day). Results: In our Center during 2016-2017 years performed 9 living donor liver transplantation. Our donors age were between 22 and 54 years. In all cases removed right lobe. From 3 donors we used 3D-laparoscopic right hepatectomy. All donors discharged at 7th-9th day after operation. Recipient’s characteristics shown in Tab.1. Died 2 recipient in late postoperative period: after infection complications (cholangiogenic abscess with sepsis and chronic rejection). Conclusions: LDLT gives a big chance to survive for patients : ith end-stage liver disease in Kazakhstan. Our transplant program needs to be gain experience, particularly with respect to donor selection, recipient preoperative preparing.

Rare Cases of Variability of Hepatic Arteries by the Results of Computed Tomography

( Diana Pay ),( Valeriy Ignatyev ),( Myltykbay Rysmakhanov ),( Rustem Abubakirov ),( Lyubov Ivanova ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

Background: Modern technological progress and the successes of anatomical science have found their application in clinical medicine, which led to a revision of the strategy and tactics of treating patients. The study of variant anatomy of the hepatic arteries remains relevant and in hepatobiliary surgery is of great practical importance. Aim: To search for and study of the new anatomical variants of Hepatic arteries based on the results of computed tomography. Methods: On the basis of the Radiology Department of the Aktobe Medical Center, 350 CT scans with contrasting of hepatic arteries of patients aged between 23 and 88 years were studied. Results: The data obtained by us have shown rare combined variations of the hepatic artery deviation: the Left hepatic artery from the Superior Mesenteric artery + Right hepatic artery from the abdominal part of the aorta; divergence of the left hepatic artery from the left gastric + right hepatic artery from the gastroduodenal artery; left hepatic artery from the left gastric + right hepatic artery from the superior mesenteric and other isolated variations. Conclusions: The analysis of the results confirms the multivariance of extrahepatic parts of Hepatic arteries: the presence of combined variants replacing and accessorial arteries, their origin from previously undescribed sources. Accurate identification of one or another variant of the structure of the trunks studied by us will help to avoid damage to them, as well as safe grafting of the transplant and proper application of arterial anastomoses to prevent ischemic manifestations in the liver.

Origin Variability of Hepatic Arteries by the Dissecting Results

( Valeriy Ignatjev ),( Diana Pay ),( Myltykbay Rysmakhanov ),( Rustem Abubakirov ),( Lyubov Ivanova ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

Aims: The results of modern anatomical studies of the human blood circulatory system continue to confirm classical works on the standard anatomy and variability of the human body. The study of variant anatomy of the hepatic arteries remains relevant, their new forms are being discovered, the presence of which is of great importance in hepatobiliary surgery. Study the anatomical variants of the hepatic arteries. Methods: The material of his own anatomical study was 48 organ complexes of a man obtained from the university long-term storage of natural preparations. The classical anatomical method of investigation - preparation was applied. Results: While investigating we revealed the following variations in the blood supply of the liver: divergence of the Left hepatic artery from the left gastric; origin of the Right hepatic artery from the abdominal part of the aorta; the Cystic artery was a branch of Proper hepatic artery; combined form: double Proper hepatic artery + double Left hepatic + double Cystic artery and other isolated variations. Conclusions: Russian surgeon N. Pirogov proved the necessity of irreproachable possession of the sum of anatomical knowledge for all doctors without exception. Our research confirms and supplements available information about a rather wide range of variability of the hepatic arteries in humans for anatomical and surgical sciences. In clinical practice deviations from classical anatomy complicate diagnosis, lead to medical errors in operative and endovascular interventions which forces surgeons to always creative and not routine treatment of patients.

Our First Experience of Living Donor Liver Transplantation

( Zhanadil Almyrzauly ),( Ermakhan Assylkhanuly ),( Erlan Sultangereev ),( Bazylbek Zhakiev ),( Asset Kaliev ),( K-w Lee ),( Myltykbay Rysmakhanov ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: Presents to analyze of first experience of Living Donor Liver Transplantation (LDLT) at Aktobe Regional Hospital, Kazakhstan, in the one-year period. LDLT were performed with the participation of specialists from SHUH. Methods: LDLT were done after the candidates (living donor and recipient) were evaluated following our practices guidelines. After donor right hepatectomies TNK solution with heparine was used for graft perfusion. “Middle hepatic vein” reconstruction performed by synthetic vascular graft. During recipient hepatectomy used “High Hillary Dissection” method. Right liver graft implantation made as standard technique. Before portal reperfusion, liver graft washed by 5% Albumine solution. Immunosupressive therapy in all patients included three components (CNI + MMF + Steroid) with introduction of intravenous Basiliximab (first and fourth postoperative day). Results: In our Hospital performed 7 living donor liver transplantation. Our donors age were between 22 and 48 years. In all cases removed right lobe. From 2 donors we used 3D-laparoscopic right hepatectomy. All donors discharged at 7th day after operation. There were no complication on liver donors. Recipient’s characteristics shown in Tab.1. Died one recipient, after infection complications (cholangiogenic abscess, sepsis). Conclusions: LDLT gives a chance to survive for patients with end-stage liver disease in Kazakhstan. Our transplant program needs to be gain experience, particularly with respect to donor selection, recipient preoperative preparing. Table 1. Recipients.