Publication: Comparative outcomes of open nephrectomy, hand-assisted laparoscopic nephrectomy, and full laparoscopic nephrectomy for living donors
Issued Date
2012-01-01
Resource Type
ISSN
18732623
00411345
00411345
Other identifier(s)
2-s2.0-84858719439
Rights
Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
Transplantation Proceedings. Vol.44, No.1 (2012), 22-25
Suggested Citation
P. Ungbhakorn, W. Kongchareonsombat, C. Leenanupan, K. Kijvikai, W. Wisetsingh, S. Patcharatrakul, S. Jirasiritam Comparative outcomes of open nephrectomy, hand-assisted laparoscopic nephrectomy, and full laparoscopic nephrectomy for living donors. Transplantation Proceedings. Vol.44, No.1 (2012), 22-25. doi:10.1016/j.transproceed.2011.12.026 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/15096
Research Projects
Organizational Units
Authors
Journal Issue
Thesis
Title
Comparative outcomes of open nephrectomy, hand-assisted laparoscopic nephrectomy, and full laparoscopic nephrectomy for living donors
Other Contributor(s)
Abstract
Objective: Kidney transplantation is a standard treatment for end-stage renal disease. There are many methods of harvesting kidneys from living donors. At present, the role of minimally invasive surgery, including hand-assisted and full laparoscopic nephrectomy, is well established and tends to replace open surgery at many institutions. We conducted a retrospective study to compare the outcomes of these operative procedures at Ramathibodi Hospital in Bangkok. Materials and methods: We retrospectively reviewed 200 patients who underwent open nephrectomy (ON), hand-assisted laparoscopic nephrectomy (HALN), and full laparoscopic nephrectomy (FLN) between January 2006 and November 2010. Demographic data, type of surgical procedure, operative time, warm ischemic time (WIT), length of hospital stay (LOH), estimated blood loss (EBL), analgesic use, and complications from surgery were recorded. Results were compared using a one-way analysis of variance in order to determine differences. Results: During the study period, 200 living kidney donors underwent nephrectomy. Of these, 95 (47.5%) received ON, 23 (11.5%) received HALN, and 82 (41%) received FLN. The operative time for the patients who underwent HALN and FLN was statistically significantly longer than that of the patients who underwent ON. On the other hand, the EBL for the ON group was significantly greater than for the HALN and FLN groups. The WIT was shortest for the ON group, followed by the HALN and FLN groups. The LOH did not differ among the three groups. Analgesic use was significantly higher in the ON group. Surgical complications were identified in 24 patients (12%). Conclusion: Our results show that laparoscopic living donor nephrectomy is a relatively safe procedure when performed by experienced surgeons at appropriate institutions. Though the operative times and WITs were slightly longer and the cost was higher for the laparoscopic groups, the EBL was lower and the pain score was lower. Indeed, laparoscopic living donor nephrectomy is an attractive alternative surgical procedure. However, there is a long learning curve and experienced surgeons are required. © 2012 Published by Elsevier Inc.
