TITLE

Comparison of Outcomes in Noncomplicated and in Higher-Risk Donors After Standard versus Hand-Assisted Laparoscopic Nephrectomy

AUTHOR(S)
Mateo, Rod B.; Sher, Linda; Jabbour, Nicolas; Singh, Gagandeep; Chan, Linda; Selby, Robert R.; El-Shahawy, Mohamed; Genyk, Yuri
PUB. DATE
September 2003
SOURCE
American Surgeon;Sep2003, Vol. 69 Issue 9, p771
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Hand-assisted techniques facilitated dissemination of the laparoscopic approach in live kidney donors and addressed concerns regarding potential procedural complications. We report our experience with both standard and hand-assisted laparoscopic nephrectomy in routine, complicated, and higher-risk donors. From July 1999 to September 2002, 47 donors underwent standard laparoscopic donor nephrectomy (SLDN; n = 29) or hand-assisted laparoscopic donor nephrectomy (HALDN; n = 18). Donors were "complicated" if they were >60 years of age, obese, refused blood-product transfusion, had multiple renal arteries or veins, or had right nephrectomies. "Higher-risk" donors had two or more risk factors. Results for SLDN and HALDN were compared for the overall groups and for the "complicated" and "higher-risk" groups. No donor required blood transfusion or reoperation. Warm-ischemia times were shorter in left nephrectomies (191± 72 seconds vs. 337 ± 95 seconds, P = 0.005), and blood loss was greater in patients with a body mass index ≥30 kg/m² (296 ± 232 mL vs. 170± 139 mL, P = 0.03). Higher-risk donors had an increased operative blood loss and longer hospital stay than low-risk donors. Mean donor creatinine at discharge was 1.19 ± 0.2 mg/dL. Comparison of SLDN versus HALDN revealed shorter operating times for the latter, which approached statistical significance. Warm-ischemia time, operative blood loss, length of hospitalization, and donor and recipient discharge creatinines were similar for both groups. Laparoscopic donor...
ACCESSION #
11063733

 

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