Laparoscopic versus open live donor nephrectomy: Outcomes analysis of 266 consecutive patients

Charles J. Dolce, Jennifer E. Keller, Kenneth C Walters, Daniel Griffin, H. James Norton, B. Todd Heniford, Kent W. Kercher

Research output: Contribution to journalArticle

20 Scopus citations

Abstract

Background: Minimally invasive surgical techniques have become the preferred method for live donor nephrectomy (DN) in many centers. We compared our experience with laparoscopic and open DN in a single institution. Methods: Data for 266 consecutive live DNs were collected. Demographic, intraoperative, and postoperative data were compared. Results: A total of 199 hand-assisted laparoscopic (HAL) DNs, 18 totally laparoscopic (TL), and 49 open DNs were performed. Laparoscopic DN was associated with a shorter operative time (p<0.013), less blood loss (p<0.0001), and shorter hospital stay (p<0.0001) than open DN. Warm ischemia time was less for HAL versus TL DN (59.9 vs. 90.0 seconds; p<0.0001). Compared with open DN, laparoscopic patients had fewer complications (p<0.03), fewer wound infections (p<0.004), less wound paresthesias (p<0.0009), and fewer complaints of chronic incisional pain (p<0.0001). Delayed graft function during the first 24 h postoperatively was significantly less for the laparoscopic DN versus the open cases (12.9% vs. 30.4%; p = 0.003), but the need for hemodialysis for the recipient was similar between groups (6.9% vs. 5%; p = not significant). Conclusions: Laparoscopic DN resulted in less blood loss, reduced operative time, and shorter hospital stay than open DN. Hand-assisted laparoscopic DN has the potential to decrease warm ischemia time for renal allografts. Donors managed laparoscopically had fewer complications, significantly less wound-related morbidity, and less delayed graft function than patients who underwent open DN.

Original languageEnglish (US)
Pages (from-to)1564-1568
Number of pages5
JournalSurgical Endoscopy
Volume23
Issue number7
DOIs
StatePublished - Jan 1 2009
Externally publishedYes

Keywords

  • Delayed graft function
  • Donor nephrectomy
  • Laparoscopic
  • Outcomes

ASJC Scopus subject areas

  • Surgery

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    Dolce, C. J., Keller, J. E., Walters, K. C., Griffin, D., Norton, H. J., Heniford, B. T., & Kercher, K. W. (2009). Laparoscopic versus open live donor nephrectomy: Outcomes analysis of 266 consecutive patients. Surgical Endoscopy, 23(7), 1564-1568. https://doi.org/10.1007/s00464-009-0340-7