TY - JOUR
T1 - Laparoscopic versus open live donor nephrectomy
T2 - Outcomes analysis of 266 consecutive patients
AU - Dolce, Charles J.
AU - Keller, Jennifer E.
AU - Walters, K. Christian
AU - Griffin, Daniel
AU - Norton, H. James
AU - Heniford, B. Todd
AU - Kercher, Kent W.
PY - 2009/7
Y1 - 2009/7
N2 - 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.
AB - 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.
KW - Delayed graft function
KW - Donor nephrectomy
KW - Laparoscopic
KW - Outcomes
UR - http://www.scopus.com/inward/record.url?scp=70349784655&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=70349784655&partnerID=8YFLogxK
U2 - 10.1007/s00464-009-0340-7
DO - 10.1007/s00464-009-0340-7
M3 - Article
C2 - 19263157
AN - SCOPUS:70349784655
SN - 0930-2794
VL - 23
SP - 1564
EP - 1568
JO - Surgical endoscopy
JF - Surgical endoscopy
IS - 7
ER -