Document Detail

Quality of life after randomization to laparoscopic versus open living donor nephrectomy: long-term follow-up.
MedLine Citation:
PMID:  17627239     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The aim of this randomized study was to compare patient-reported outcome after laparoscopic versus open donor nephrectomy during 1 year follow-up. The evidence base has so far not allowed for a decision as to which method is superior as seen from a long-term quality of life-perspective. METHODS: The donors were randomized to laparoscopic (n=63) or open (n=59) nephrectomy, with follow-up at 1, 6, and 12 months. Primary outcomes were health status (SF-36) and overall quality of life (QOLS-N). Secondary outcomes were donor perception of the surgical scar, the donation's impact on personal finances, and whether the donor would make the same decision to donate again. RESULTS: There was a significant difference in favor of laparoscopic surgery regarding the SF-36 subscale bodily pain at 1 month postoperatively (P<0.05). Analysis based on intention to treat revealed no long-term differences between groups in SF-36 scores. When subtracting the reoperated/converted donors of the laparoscopic group, significant differences in favor of laparoscopy were revealed in the subscales bodily pain at 6 months (P<0.05) and social functioning at 12 months (P<0.05). No significant differences were found in QOLS-N scores between groups. CONCLUSIONS: Laparoscopic donor nephrectomy is an attractive alternative to open donor nephrectomy because of less postoperative pain. However, long-term comparison only revealed significant differences in favor of laparoscopy when adjusting for reoperations/conversions. Both groups reached baseline scores in most SF-36 subscales at 12 months and this may explain why possible minor benefits are hard to prove.
Marit Helen Andersen; Lars Mathisen; Marijke Veenstra; Ole Oyen; Bjørn Edwin; Randi Digernes; Gunnvald Kvarstein; Tor Inge Tønnessen; Astrid Klopstad Wahl; Berit Rokne Hanestad; Erik Fosse
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Transplantation     Volume:  84     ISSN:  0041-1337     ISO Abbreviation:  Transplantation     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-07-13     Completed Date:  2007-08-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0132144     Medline TA:  Transplantation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  64-9     Citation Subset:  IM    
Department of Surgery, Rikshospitalet-Radiumhospitalet Medical Centre, Oslo, Norway.
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MeSH Terms
Health Status
Interpersonal Relations
Living Donors*
Longitudinal Studies
Middle Aged
Nephrectomy / methods*
Pain, Postoperative / physiopathology
Postoperative Period
Quality of Life*
Time Factors

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