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.
Yohannes
Paulos
P
Department of Surgery, Creighton University, Omaha, Nebraska 68131, USA. Pyohannes@hotmail.com
Rao
Malini
M
Burjonrappa
Sathyaprasad
S
Sudan
Ranjan
R
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