Retroperitoneoscopic donor nephrectomy: donor outcome and complication rate in comparison with three different techniques

Abstract

Four surgical techniques for living donor nephrectomy were analyzed retrospectively in terms of perioperative outcome and early complication rate. A total of 182 donor nephrectomies including 69 open (OLDN), 14 fully laparoscopic (LDN), 34 hand-assisted laparoscopic (HLDN) and 65 retroperitoneoscopic (RLDN) nephrectomies were analyzed. There was a significant difference in mean operating time (OPT) between the OLDN (160 min) and RLDN (150 min) as compared to the LDN (212 min) and HLDN group (192 min) (P < 0.001). Mean warm ischemia time (WIT) was significantly shorter with OLDN (114 s), RLDN (121 s) and HLDN (128 s) when compared to LDN (238 s) (P < 0.001). Major complication rate was comparable among the groups. Independent of the preferred technique, donor nephrectomy is associated with complication rates. RLDN is comparable to OLDN in terms of OPT, WIT. Learning endoscopic donor nephrectomy could be associated with a higher complication rate.

Complications of retroperitoneoscopic living donor nephrectomy: single center experience after 164 cases

“…When compared to fully laparoscopic and hand-assisted laparoscopic living donor nephrectomy performed in other centers, we experienced lower OTs and WITs with RLDN [17,[23][24][25][26]. Furthermore, we found similar OTs and WITs compared to our own open series [27].…”

Comparing Surgical Complications of Donors and Recipients in Retroperitoneoscopic versus Mini-Incision Donor Nephrectomy: A Single-Center Experience

“…A study of Buell et al compared a laparoscopic and retroperitoneoscopic approach for the right-sided nephrectomy in two different clinics in Ohio and stated that both techniques were safe with a longer operation time in the laparoscopic approach [18]. Ruszat et al compared laparoscopic, open, and retroperitoneoscopic nephrectomies in Basel, Switzerland, pointing out a shorter operation time and faster learning curve for the retroperitoneoscopic nephrectomy [19]. These data and training in the Department of Urology in Basel, Switzerland encouraged us to reevaluate our centre policy of MIDN for living kidney donation.…”

Open Donor Nephrectomy is a Safe Approach for Starting Kidney Transplantation

“…But, such serious complications as donor mortality about 1out of 3000 living donor nephrectomies, bleeding, bowel and adjacent organ injuries, pleural and pulmonary complication ocur (8)(9)(10)(11) (4,11). And also warm ischemic or total ischemic time and operating time are longer than open techniques (8,12). The standard open extraperitoneal or transperitoneal approaches have proved to be a safe approach for donor nephrectomy during the past 50 years (8).…”

“…And also warm ischemic or total ischemic time and operating time are longer than open techniques (8,12). The standard open extraperitoneal or transperitoneal approaches have proved to be a safe approach for donor nephrectomy during the past 50 years (8). It has a low complication rate (8).…”

“…The standard open extraperitoneal or transperitoneal approaches have proved to be a safe approach for donor nephrectomy during the past 50 years (8). It has a low complication rate (8). Most surgeons are more confident and familiar with this approach (8).…”