title: 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.
authors.affiliation: Department of Urology, University Hospital Basel, Spitalstr. 21, 4031 Basel, Switzerland. rruszat@uhbs.ch
authors.forename: Robin
authors.initials: R
authors.lastname: Ruszat
authors.forename: Tullio
authors.initials: T
authors.lastname: Sulser
authors.forename: Michael
authors.initials: M
authors.lastname: Dickenmann
authors.forename: Thomas
authors.initials: T
authors.lastname: Wolff
authors.forename: Lorenz
authors.initials: L
authors.lastname: Gürke
authors.forename: Thomas
authors.initials: T
authors.lastname: Eugster
authors.forename: Igor
authors.initials: I
authors.lastname: Langer
authors.forename: Peter
authors.initials: P
authors.lastname: Vogelbach
authors.forename: Jürg
authors.initials: J
authors.lastname: Steiger
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Gasser
authors.forename: Christian G
authors.initials: CG
authors.lastname: Stief
authors.forename: Alexander
authors.initials: A
authors.lastname: Bachmann
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D016030:Kidney Transplantation; D020706:Laparoscopes; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D010149:Postoperative Pain / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D011336:Probability; D012187:Retroperitoneal Space; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D013997:Time Factors