Investig Clin Urol.  2021 Mar;62(2):172-179. 10.4111/icu.20200424.

Pure laparoscopic donor nephrectomy without routine drainage does not increase postoperative morbidity

Affiliations
  • 1Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
  • 2Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
  • 3Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea
  • 4Department of Urology, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

Abstract

Purpose
We aimed to define the feasibility of the omission of routine insertion of a drain after pure laparoscopic donor nephrectomy (PLDN). We compared the outcomes between those with and without routine drain insertion.
Materials and Methods
From July 2014 to October 2018, 178 PLDN were consecutively performed by a single surgeon. Since October 2016, we stopped routine insertion of a drain after PLDN. Thus, the former 80 drained routinely were defined as the Drainage group and the latter 98 were defined as the Non-drainage group. One patient drained non-routinely in the Non-drainage group was excluded from the final analysis. Operative and convalescence parameters and intra- and postoperative complications were compared between the groups. Intra- and postoperative complications within 90 days of surgery were graded using the Satava and Clavien–Dindo classifications, respectively.
Results
Baseline characteristics were similar between the groups, except for concomitant surgery, American Society of Anesthesiologists score, and preoperative glomerular filtration rate. All operative and convalescence parameters were similar between the groups, except for postoperative glomerular filtration rate. The rates of overall intra- (22.5% versus 28.9%, p=0.337) and postoperative (62.5% versus 59.8%, p=0.713) complications were similar between the groups. The rates of potentially drain-related postoperative complications were also similar between the groups (36.3% versus 33.0%, p=0.650). Two patients per group suffered from major drain-related complications (2.5% versus 2.1%).
Conclusions
PLDN without routine drainage can be performed safely without an increase in postoperative morbidity.

Keyword

Drainage; Intraoperative complications; Laparoscopy; Living donors; Postoperative complications
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