Minimal incision living donor nephrectomy: improvement in patient outcome.
OBJECTIVE
To analyze the minimal incision living donor (MILD) nephrectomy and compare it with the standard open donor (SOD) nephrectomy with respect to incision size, operative time, complication rate, length of hospital stay, and recipient creatinine.


METHODS
Forty-five consecutive patients who underwent MILD nephrectomy were compared with 13 patients who had previously undergone SOD nephrectomy. The MILD nephrectomy was performed through a minimally invasive incision using a modified, anterolateral, retroperitoneal approach without a rib resection. The incision length, operative time, complication rates, length of hospital stay, and recipient creatinine were analyzed.


RESULTS
The average incision length in the MILD group was 8.6 cm compared with 21.8 cm in the SOD group (P >0.005.) The operative times (209 minutes in the MILD group versus 191 minutes in the SOD group) were not significantly different. Four postoperative complications were encountered in the SOD group and seven in the MILD group. The average hospital stay for the MILD patients was 2.5 days compared with 4.6 days in the SOD group, and as the procedure was refined, the length of stay was reduced to 1 day in 3 patients. The recipient creatinine at 1 and 6 months was 1.39 and 1.4 mg/dL in the MILD group, respectively.


CONCLUSIONS
The MILD nephrectomy allows the patient to undergo a less morbid procedure with a more aesthetic incision. Patients have fewer complications, minimal anesthesia exposure, and short hospital stays.
Yang
Shuin-Lin
SL
Department of Kidney Transplantation, Albert Einstein Medical Center, Philadelphia, Pennsylvania 19141, USA.
Harkaway
Richard
R
Badosa
Francisco
F
Ginsberg
Phillip
P
Greenstein
Marc A
MA
D000328:Adult; D000698:Analgesia; D005260:Female; D006801:Humans; D007668:Kidney; D007902:Length of Stay; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D009392:Nephrectomy / Q000379:methods*; D020858:Tissue and Organ Harvesting / Q000379:methods*