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Surg Endosc. 2009 Jul;23(7):1564-8. doi: 10.1007/s00464-009-0340-7. Epub 2009 Mar 5.

Laparoscopic versus open live donor nephrectomy: outcomes analysis of 266 consecutive patients.

Author information

1
Department of Surgery, Division of Gastrointestinal and Minimally Invasive Surgery, Carolinas Medical Center, Charlotte, NC, USA. charles.dolce@carolinashealthcare.org

Abstract

BACKGROUND:

Minimally invasive surgical techniques have become the preferred method for live donor nephrectomy (DN) in many centers. We compared our experience with laparoscopic and open DN in a single institution.

METHODS:

Data for 266 consecutive live DNs were collected. Demographic, intraoperative, and postoperative data were compared.

RESULTS:

A total of 199 hand-assisted laparoscopic (HAL) DNs, 18 totally laparoscopic (TL), and 49 open DNs were performed. Laparoscopic DN was associated with a shorter operative time (p < 0.013), less blood loss (p < 0.0001), and shorter hospital stay (p < 0.0001) than open DN. Warm ischemia time was less for HAL versus TL DN (59.9 vs. 90.0 seconds; p < 0.0001). Compared with open DN, laparoscopic patients had fewer complications (p < 0.03), fewer wound infections (p < 0.004), less wound paresthesias (p < 0.0009), and fewer complaints of chronic incisional pain (p < 0.0001). Delayed graft function during the first 24 h postoperatively was significantly less for the laparoscopic DN versus the open cases (12.9% vs. 30.4%; p = 0.003), but the need for hemodialysis for the recipient was similar between groups (6.9% vs. 5%; p = not significant).

CONCLUSIONS:

Laparoscopic DN resulted in less blood loss, reduced operative time, and shorter hospital stay than open DN. Hand-assisted laparoscopic DN has the potential to decrease warm ischemia time for renal allografts. Donors managed laparoscopically had fewer complications, significantly less wound-related morbidity, and less delayed graft function than patients who underwent open DN.

PMID:
19263157
DOI:
10.1007/s00464-009-0340-7
[Indexed for MEDLINE]
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