Document Detail


Open versus laparoscopic donor nephrectomy: perioperative parameters and graft functions.
MedLine Citation:
PMID:  21486597     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVE: With the developments in laparoscopic surgery, open donor nephrectomy has been widely replaced by laparoscopic donor nephrectomy. Presented herein is the comparison of laparoscopic live donor nephrectomy (LLDN) and open live donor nephrectomy (OLDN) results performed at our institute.
MATERIALS AND METHODS: Patients who underwent OLDN between July 2006 and August 2008 or LLDN between August 2008 and July 2010 were included in this retrospective age- and gender-matched case-controlled study. OLDN was performed with a 45° semi-flank position using a self-retaining retractor. LLDN operations were performed used a 90° flank position by the transperitoneal route under 12-15 mm Hg carbon dioxide (CO(2)) pressure. A Pfannenstiel incision was used in all LLDN for graft extraction. The renal artery and vein were controlled with Satinsky clamps in OLDN, whereas renal arteries were controlled with nonabsorbable polymer locking clips and renal veins with 2.5/45 mm EndoGIA vascular staplers in LLDN.
RESULTS: Thirty patients underwent OLDN and 31 LLDN. The mean ages among the OLDN and LLDN patients were 44.9 ± 21.9 and 46.3 ± 18.4, respectively. There was no significant difference in mean age and gender distribution of patients between OLDN and LLDN groups by the design of the study. The OLDN group consisted of 4 (13%) right and 26 (87%) left nephrectomies; the LLDN group consisted of 3 (9%) right and 28 (91%) left nephrectomies. Mean operative time was 110 ± 18 and 101 ± 28 minutes for OLDN and LLDN, respectively (P < .05; Mann-Whitney U test). Estimated blood loss was 35 ± 15 mL among the OLDN group and 15 ± 24 mL for the LLDN group. Mean hospitalization time in the OLDN and LLDN groups were 3.8 ± 0.5 and 2.6 ± 0.6 days, respectively. There were no conversions to open surgery in the LLDN group. Mean warm ischemia time in the OLDN and LLDN groups were 140 ± 58 seconds and 203 ± 21 seconds, respectively (P < .05; Mann-Whitney U test). There was no difference in recipient serum creatinine levels at 1 week after surgery.
CONCLUSION: LLDN was superior to OLDN in terms of operative time, estimated blood loss, length of hospital stay, and postoperative pain. Longer warm ischemia time in the LLDN group did not translate into worse graft function in the recipients.
Authors:
M Altinel; S Akinci; Z E Gunes; E Olcucuoglu; F Gonenc; A H Yazicioglu
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Transplantation proceedings     Volume:  43     ISSN:  1873-2623     ISO Abbreviation:  Transplant. Proc.     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-04-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0243532     Medline TA:  Transplant Proc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  781-6     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Affiliation:
1(st) and 2(nd) Urology Clinics, Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey.
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