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What is it about?
This study assessed the safety of vascular closure devices in living-donor nephrectomy using a systematic review and meta-analysis of comparative and non-comparative studies. There were no significant differences in rates of device failure, severe hemorrhage, conversion to open surgery, or mortality between clips and staplers. However, there was weak evidence suggesting that device failure was lower in the polymer clip group. The study concluded that there is no evidence for the superiority of any vascular closure device in terms of safety in LDN, and that standardized recommendations for vascular control in this context should be carefully designed and prospectively evaluated.
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Why is it important?
This research is important because it assesses the safety of vascular closure devices in living-donor nephrectomy (LDN), a surgical procedure that involves the removal of a kidney from a living donor. The study provides a systematic review and meta-analysis of comparative and non-comparative studies to evaluate the safety of vascular closure devices, including staplers and non-transfixion techniques such as polymer locking and metal clips. The use of clips has come into question since the United States Food and Drug Administration and manufacturers issued a contraindication. Therefore, this research helps to provide evidence on the safety of vascular closure devices, which is essential for surgeons and healthcare professionals to make informed decisions about the best methods for securing the renal vessels during laparoscopic and robotic LDN. The study also highlights the need for standardized recommendations for vascular control in LDN, which should be carefully designed and prospectively evaluated. Key Takeaways: 1. The study provides a systematic review and meta-analysis of comparative and non-comparative studies to assess the safety of vascular closure devices in living-donor nephrectomy. 2. The study found no significant differences in death rate, severe haemorrhage, or need for conversion to open surgery between the use of staplers and polymer clips. 3. The study did find a lower incidence of device malfunction in the polymer clip group, but it was based on weak evidence. 4. The study highlights the need for standardized protocols to be carefully designed and further research to evaluate such recommendations.
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This page is a summary of: Vascular closure devices in living‐donor nephrectomy: a much‐needed systematic review and meta‐analysis focusing on safety, BJU International, June 2023, Wiley,
DOI: 10.1111/bju.16025.
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