Laparoscopic surgery has been a standard procedure of living donor nephrectomy. Transperitoneal hand-assisted laparoscopic living donor nephrectomy (HALDN) has been commonly reported by many centers with excellent outcome. However, there are few studies reporting retroperitoneoscopic living donor nephrectomy (RPLDN).
Four hundred four consecutive kidney donors (124 men, 280 women) were enrolled in this study. Age of the donors was 55.0 ± 10.7 years. RPLDN was performed for 294 donors, and HALDN for 110 donors. We compared perioperative donor outcome and early complication rates between RPLDN and HALDN to evaluate the safety and efficacy of RPLDN.
Intraoperative blood loss was significantly less in the RPLDN than in HALDN (P<0.05). The conversion rate to open surgery was similar between the two groups. The intraoperative complication rate was 1.0% (2 vascular injury, 1 bowel injury) in RPLDN and 0.9% (1 vascular injury) in HALDN. The postoperative complication rate was 3.4% (6 surgical site infection, 2 postoperative bleeding, 1 ileus, 1 rhabdomyolysis) in RPLDN and 1.8% (2 surgical site infection) in HALDN. Although warm ischemic time was significantly longer in RPLDN than in HALDN (P<0.01), the incidence of delayed graft function was similar between the two groups. Furthermore, there was no difference in 1-year graft survival between the two groups.
Both RPLDN and HALDN procedures were well tolerated with minimal complication rates, and both procedures showed similar impact on recipient graft function. These results suggest that RPLDN could be a feasible option for living donor nephrectomy as well as HALDN. .
Journal of endourology. 2018 Nov 06 [Epub ahead of print]
Takayuki Hirose, Kiyohiko Hotta, Daiki Iwami, Hiroshi Harada, Ken Morita, Tatsu Tanabe, Hajime Sasaki, Nobuyuki Fukuzawa, Toshimori Seki, Nobuo Shinohara
Hokkaido University Hospital, Urology, Sapporo, Japan ; ., Hokkaido University Hospital, Urology , Kitaku Kita14 Nishi 5 , Sapporo, Japan , 060-8648 ; ., Hokkaido University Hospital, Urology, Sapporo, Japan ; ., Sapporo City General Hospital, 13618, Sapporo, Japan ; ., Kushiro City General Hospital, 37068, Kushiro, Hokkaido, Japan ; ., Hokkaido University Hospital, Urology, Sapporo, Japan ; ., Hokkaido University Hospital, 163693, Urology, Sapporo, Hokkaido, Japan ; ., Sapporo City General Hospital, Urology , 1-1, kita 11, nishi 13 , chuou-ku , Sapporo, Hokkaido, Japan , 060-8604 ; ., Sapporo City General Hospital, 13618, Urology, Sapporo, Japan ; ., Hokkaido University Hospital, Urology, Sapporo, Japan ; .