Laparoscopic nephron-sparing surgery in a Jehovah's Witness patient.
An obese 76-year-old woman with type II diabetes, hypertension, coronary artery disease, and gastroesophageal reflux was found to have a 6-cm lower-pole mass in a solitary functional right kidney. Because her religious beliefs prohibited blood transfusion, minimally invasive surgery--a laparoscopic partial nephrectomy--was performed, with a good result. Minimally invasive surgery, perhaps with administration of erythropoietin, iron-dextran, or both, is often a good option for severely anemic patients or those whose religious beliefs are opposed to transfusion. Methods of minimizing blood loss intraoperatively are reviewed.
Department of Surgery, Creighton University, Omaha, Nebraska 68131, USA. Pyohannes@hotmail.com
Paulos
P
Yohannes
Malini
M
Rao
Sathyaprasad
S
Burjonrappa
Ranjan
R
Sudan
D000368:Aged; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D003327:Coronary Disease / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D004921:Erythropoietin / Q000627:therapeutic use; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications; D006801:Humans; D006973:Hypertension / Q000150:complications; D007505:Iron-Dextran Complex / Q000627:therapeutic use; D033221:Jehovah's Witnesses; D007680:Kidney Neoplasms / Q000601:surgery*; D010535:Laparoscopy; D009392:Nephrectomy / Q000379:methods*
D004921:Erythropoietin; D007505:Iron-Dextran Complex