Live donor nephrectomy and return to work: does the operative technique matter?
BACKGROUND
Several studies report an earlier return to work after minimal invasive kidney donation compared to open donor nephrectomy. However, this variation in outcome might be influenced by other factors than the surgical technique used, such as the advice given by the physician regarding return to work. In this study, we compare the absence from work after open (ODN), laparoscopic (LDN), and hand-assisted donor nephrectomy (HA) performed in the Netherlands, in relation to the advice given.


METHODS
Questionnaires containing questions about return to work or return to daily activities were sent to 78 donors from three hospitals. In the HA and ODN hospitals, advice on full return to work was 3 months. In contrast, advice given in the LDN hospital was 6 weeks.


RESULTS
After LDN, donors resumed their work after 6 weeks, 5 weeks faster compared to ODN (p = 0.002) and HA (p <0.001). Complete return to work occurred 9 weeks sooner in the LDN group compared to the ODN and HA groups (both p <0.001). In the unemployed group, there was no significant difference in length until full return to daily activities.


CONCLUSIONS
Return to work is influenced by the advice on return to work given by the physician as well as the morbidity associated with the surgical approach.
Lind
M Y
MY
Department of Surgery, Erasmus MC, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands. lind@hlkd.azr.nl
Liem
Y S
YS
Bemelman
W A
WA
Dooper
P M M
PM
Hop
W C J
WC
Weimar
W
W
Ijzermans
J N M
JN
D000041:Absenteeism; D000203:Activities of Daily Living; D006801:Humans; D016030:Kidney Transplantation; D010535:Laparoscopy; D019520:Living Donors; D009392:Nephrectomy / Q000379:methods / Q000706:statistics & numerical data