Comparison of Hand-assisted Laparoscopic Donor Nephrectomy with Open Donor Nephrectomy

Baik, Seung; Rho, Joon; Kim, Chul Sung

Abstract

PURPOSE: To assess the efficacy, morbidity and patient recovery of hand- assisted laparoscopic donor nephrectomy (HALDN), we compared our initial experience with HALDN to that of the standard open donor nephrectomy (ODN).
MATERIALS AND METHODS
Between March 2002 and March 2004, one surgeon performed 18 cases of HALDN and 9 cases of ODN at our institution. Operative outcome were reviewed, including operative time, warm ischemic time, blood loss, time to oral intake, length of hospital stay, postoperative analgesic requirement, complications and graft function.
RESULTS
The mean operative time was 232 minutes and 192 minutes (p<0.01), and the mean warm ischemic time was 185 seconds and 168 seconds (p=0.28) for HALDNs and ODNs, respectively. The mean blood loss and time to oral intake were similar. The mean hospital stay was 4.3 days and 8.7 days (p<0.01), and the mean analgesic dose was 80mg of piroxicam and 260mg of piroxicam (p<0.01) for HALDNs and ODNs, respectively. No patient required open conversion. Complications occurred in 2 cases in HALDNs and in 1 case in ODNs. All donated kidneys were transplanted with immediate good function. The recipients' serum creatinine level at 1, 2, and 3 years after transplantation showed no significant difference between the two groups.
CONCLUSIONS
HALDN is technically feasible and appears to be a safe and effective surgical method. HALDN provides the donor with faster convalescence, while maintaining a healthy renal allograft function for the recipient.