title: Retroperitoneoscopic live donor nephrectomy: extended experience in a single center.
abstract: BACKGROUND
  Retroperitoneoscopic live donor nephrectomy (RPLDN) was performed because it is considered to be less invasive than open live donor-nephrectomy (OLDN) or transperitoneal laparoscopic live donor nephrectomy.
  
  
  METHODS
  Between July 2001 and May 2003, 118 consecutive live donor kidney grafts were procured using RPLDN or OLDN. The patients who underwent RPLDN were divided into 2 groups: an initial group 1 (n = 38) and a subsequent group 2 (n = 48).Thirty-two patients who underwent OLDN during the same period were used as controls (group 3). The patients were placed in the lateral position. Three retroperitoneoscopic ports were inserted. The kidneys were retrieved through a 5-cm flank incision just below the 11th rib in group 1. In group 2, a 5-cm Pfannenstiel incision was used to extract the kidney.
  
  
  RESULTS
  The operative time was 307 +/- 88 minutes, 245 +/- 42 minutes, and 215 +/- 70 minutes in groups 1, 2, and 3, respectively (group 1 vs group 2 or 3, P < .01). The mean postoperative pentazocine (painkiller) requirements were 12 mg, 4.4 mg, and 22 mg in groups 1, 2, and 3, respectively (group 2 vs group 1 or 3, P < .01). The hospital stay was 6.6 +/- 1.6, 4.9 +/- 0.7, and 7.0 +/- 0.1 days in groups 1, 2, and 3, respectively (group 2 vs group 1 or 3, P < .01). There were no serious complication, such as massive bleeding or bowel injury.
  
  
  CONCLUSIONS
  RPLDN may be safer and less invasive than open donor nephrectomy.
authors.affiliation: Section of Renal Transplantation/Renovascular Surgery, Department of Urology, Tokyo Women's Medical University, Tokyo, Japan. tanabe@kc.twmu.ac.jp
authors.forename: K
authors.initials: K
authors.lastname: Tanabe
authors.forename: N
authors.initials: N
authors.lastname: Miyamoto
authors.forename: T
authors.initials: T
authors.lastname: Tokumoto
authors.forename: H
authors.initials: H
authors.lastname: Yamamoto
authors.forename: H
authors.initials: H
authors.lastname: Ishida
authors.forename: T
authors.initials: T
authors.lastname: Kondo
authors.forename: H
authors.initials: H
authors.lastname: Okuda
authors.forename: H
authors.initials: H
authors.lastname: Shinmmura
authors.forename: H
authors.initials: H
authors.lastname: Shirakawa
authors.forename: T
authors.initials: T
authors.lastname: Shimizu
authors.forename: N
authors.initials: N
authors.lastname: Ishikawa
authors.forename: H
authors.initials: H
authors.lastname: Toma
mesh_terms: D006801:Humans; D007564:Japan; D016030:Kidney Transplantation / Q000502:physiology*; D019520:Living Donors; D009392:Nephrectomy / Q000379:methods*; D012187:Retroperitoneal Space; D012189:Retrospective Studies; D020858:Tissue and Organ Harvesting / Q000379:methods; D016896:Treatment Outcome