Postoperative Pain and Convalescence in Living Kidney Donors—Laparoscopic Versus Open Donor Nephrectomy: A Randomized Study

Abstract

The aim of the present study was to compare postoperative pain and convalescence in patients randomized to laparoscopic or open donor surgery in a prospective, controlled trial. The donors were randomly assigned to undergo laparoscopic (n = 63) or open (n = 59) donor nephrectomy. Our end points were amount of administered analgesics in the recovery period, postoperative pain on the second postoperative day and at one month after surgery and duration of sick leave. There was a significant difference in favor of the laparoscopic group regarding administered analgesics on day of surgery (p < 0. 02). No difference was observed between groups regarding self-reported pain on the second postoperative day. One month post donation, significantly fewer donors in the laparoscopic group reported pain (p < 0. 02) or had used analgesics (p < 0.05). The duration of sick leave was significantly shorter in the laparoscopic group (p = 0.01). The laparoscopic group experienced a more rapid convalescence and a shorter period of sick leave. Although immediate postoperative pain can be managed efficiently regardless of procedure, a lower consumption of opioids and incidence of pain in the convalescent period suggest a clinically relevant patient-experienced benefit from a successful laparoscopic procedure.

Laparoscopic Kidney Transplantation: An Initial Experience

“…Since then many centers have adopted LDN as the standard of care. In comparison to open donor nephrectomy (ODN), LDN has advantages of less pain, early ambulation, better cosmesis and rapid convalescence (2)(3)(4)(5)(6). Despite the physiological changes that occur due to pneumoperitoneum, early and late outcome of renal allograft transplantation have not shown significant difference between ODN and LDN groups (7).…”

Early and Late Graft Function after Laparoscopic Hand-Assisted Donor Nephrectomy for Living Kidney Transplantation: Comparison with Open Donor Nephrectomy

“…Thus, in many transplant centers laparoscopic donor nephrectomy (LDN) has become the preferred method of choice in the live kidney donation [5] . The reason for this is the superior benefits of minimally invasiveness nature of laparoscopic techniques [6] . However, there is some controversial discussion about the adverse effect of possible longer warm ischemia time during the laparoscopic donor nephrectomy on recipients graft function [7] .…”

Cumulative Sum Analysis of the Learning Curve for Modified Retroperitoneoscopic Living-Donor Nephrectomy

“…Compared with the open procedure, LLDN has the benefit of lower complication rates and perioperative events along with similar long-term outcomes [5,6]. LLDN also has the advantages of less postoperative pain, decreased length of hospital stay with rapid recovery, and enhanced cosmesis [7]. Compared with LLDN, retroperitoneoscopic living-donor nephrectomy (RPLDN) has the additional intraoperative advantage of providing direct access to the renal pedicles and avoiding potential injury to the intraperitoneal organs [8].…”