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Laparoscopic vs open living donor nephrectomy: a contemporary series from one centre
Author(s) -
POWER RICHARD E.,
PRESTON JOHN M.,
GRIFFIN ANTHONY,
MARTIN IAN,
WALL DARYL R.,
NICOL DAVID L.
Publication year - 2006
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2006.06265.x
Subject(s) - medicine , nephrectomy , surgery , laparoscopy , prospective cohort study , general surgery , kidney
Laparoscopic versus open living‐donor nephrectomy has become a frequent debate amongst urologists involved in this area of expertise, with the laparoscopic argument being most popular at present. Authors from Australia describe a prospective comparative trial using both techniques, finding that the laparoscopic approach could be introduced without compromising results. Authors from the USA describe their experience with cystinuria, and suggest measures that might be taken to reduce the number of surgical procedures required in their treatment. OBJECTIVES To report our experience of laparoscopic living donor nephrectomy (LDN) vs open donor nephrectomy (ODN), as LDN offers potential advantages to the donor and has become a routine procedure for live kidney procurement worldwide. PATIENTS AND METHODS Between February 2000 and August 2005 we performed 183 donor‐recipient operations at our institution (ODN, 83; LDN, 100). We prospectively collected information on all donors and recipients for the same period to audit our experience with the first 100 LDNs. Patients made their operative choice after discussions that included unit experience and published information. We present our findings with the emphasis on donor operative details and early recipient graft outcome. RESULTS Donor and recipient age, gender, body mass index, human leukocyte antigen mismatches, and vascular anastomotic times did not differ significantly between the groups. There were two conversions to an open operation in the LND group; neither affected recipient‐graft outcome. The mean ( sd ) operative duration was 178 (38) min for the LDN and 159 (34) min for the ODN ( P < 0.05). The mean ( sd ) hospital stay was 4.7 (1.2) days in the LND group and 6.8 (1.5) days in the ODN group ( P < 0.05). There was one case of delayed graft function in both groups. Serum creatinine levels at 1, 6 and 12 months after transplantation did not differ significantly between the groups. CONCLUSIONS Our contemporaneous series shows the safe introduction of a laparoscopic living‐donor programme without compromising donor patient safety or allograft outcome.