Document Detail


Randomized clinical trial of laparoscopic versus open donor nephrectomy.
MedLine Citation:
PMID:  19937983     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: This randomized controlled trial was designed to determine the safety and efficacy of laparoscopic donor nephrectomy (LDN) in comparison with short-incision open donor nephrectomy (ODN). METHODS: Eighty-four live kidney donors were randomized in a 2 : 1 ratio to LDN (56 patients) or short-incision ODN without rib resection (28). Primary endpoints were pain relief and duration of inpatient stay. RESULTS: There was no donor death or allograft thrombosis in either group. The first warm ischaemic time median (range) 4 (2-7) versus 2 (1-5) min; P = 0.001) and the duration of operation (160 (110-250) versus 150 (90-200); P = 0.004) were longer for LDN. LDN led to a reduction in parenteral morphine requirement 59 (6-136) versus 90 (35-312) mg; P = 0.001) and hospital stay (4 (2-6) versus 6 (2-9) days; P = 0.001), and earlier return to employment (42 (14-84) versus 66.5 (14-112) days; P = 0.004). Postoperative respiratory function was improved after LDN. There were more postoperative complications per donor in the ODN group (0.6(0.7) versus 0.3(0.5); P = 0.033). At a median follow-up of 74 months, there were no differences in renal function or allograft survival between the groups. CONCLUSION: LDN removes some of the disincentives to live donation without compromising the outcome of the recipient transplant.
Authors:
M L Nicholson; M Kaushik; G R R Lewis; N R Brook; A Bagul; M D Kay; S J Harper; R Elwell; P S Veitch
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The British journal of surgery     Volume:  97     ISSN:  1365-2168     ISO Abbreviation:  Br J Surg     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2009-12-17     Completed Date:  2009-12-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372553     Medline TA:  Br J Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  21-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Affiliation:
Transplant Surgery Group, Department of Infection, Immunity and Inflammation, University of Leicester, Leicester General Hospital, Gwendolen Road, Leicester LE5 4PW, UK. mln2@le.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Analgesics, Opioid / therapeutic use
Female
Humans
Intraoperative Complications / etiology
Kidney Transplantation / methods*
Laparoscopy / methods*
Length of Stay
Living Donors*
Male
Middle Aged
Morphine / therapeutic use
Nephrectomy / methods*
Pain, Postoperative / prevention & control
Postoperative Complications / etiology
Prognosis
Respiratory Function Tests
Tissue and Organ Harvesting / methods*
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; 57-27-2/Morphine

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