Kidney transplantation in PKD patient with ESDR is the optimal solution, ameliorating expectancy and restoring a better life quality.
Forthermore liver-kidney transplantation has to be considered the best treatment for both organs insufficiency.
Nephrectomy it is not routinely needed, but has to be performed only in selected cases, using, when possible, mini invasive techniques and methods, saving peritoneal space and using minimal incision.
Not in all Centres a consistent number of surgical specific procedures for PKD is performed and continuous experience is crucial to obtain successful results.
We have achieved a great experience with a traditional approach for this type of surgery with kidney transplant technique and this has allowed us to modify the surgical technique in mini-invasive way.
KIDNEY REMODELLING BY NEEDLE ASPIRATION BEFORE NEFHRECTOMY.
In this way the isolated kidney is subjected to needle suctions with geometric specific and aseptic cists drainage. Incisional length is very small (11-12 cm long) and costotomy and partial rib ablation are unnecessary. Operation time is about one hour (50-90 minutes) and the hospital stay is about one week.
Morevore in our experience we did not experience any specific complication.
In case of PKD open nephrectomy using volumetric kidney remodelling is safe and successful with small incisional length, and with rib and peritoneal space integrity respect.
This technique allows removing very big kidneys without increase of intra- and peri-surgical complications rate and also does not sensibly prolong operating time.
In subjects with a positive family history, radiologic diagnose is possible by matching number and size of the cysts and patient age.
Generally, ultrasounds is the first investigation because of it's safety and low cost and it can easily show cysts from 1 cm. of diameter and it is considered a high sensitivity technique.
CT and MR scan increase detection rate in cysts less 1 cm. and allow detecting, quantifying and monitoring over time kidney volume and mass structure.
Contacts:
Fedele Lasaponara M.D.
Urologist
Studio S.U.M. Via Cellini 17 Turin, Italy Ph: +39 011 6633335
Clinica Sedes Sapientiae Via Bidone 31 Turin, Italy Ph: +39 011 467 7811
Kidney Disease (PKD) is a multisystemic pathology characterized by bilateral kidney cysts that frequently evolve in end-stage renal disease (ESDR).
This is one of most common genetic disease and accounts for about 10% of chronic dialytic causes in Italy.
PKD Polycystic Kidney Disease
Fedele Lasaponara M.D.
Urologist
S.U.M. Medical Office, Via Cellini 17 Turin, Italy
Ph: (+39)011 6633335
Sedes Sapientiae Medical Healt, Via Bidone 31 Turin, Italy
Ph: (+39) 011 467 7811
