Psychosocial and physical impairment after mini-incision open and laparoscopic donor nephrectomy: A prospective study.
BACKGROUND
The aim of the present study was to prospectively investigate how mini-incision donor nephrectomy (MIDN) and laparoscopic donor nephrectomy (LDN) affected the donor's quality of life and fatigue.


METHODS
Forty-five donors underwent MIDN and 55 donors underwent LDN. Quality of life and fatigue were recorded preoperatively and four times during one year follow-up on the Short-Form 36 (SF-36) and Multidimensional Fatigue Inventory-20 (MFI-20), respectively.


RESULTS
One-year response rates were 89% and 95% following MIDN and LDN, respectively. After MIDN, all dimensions of the SF-36 significantly declined. Most dimensions returned to preoperative values at three months except for "vitality" (six months) and "bodily pain" (12 months). After LDN, the scores of the SF-36 dimensions returned to preoperative values at three months, except for "vitality" and "role physical" (both six months). Between-groups analysis revealed significantly better scores of the SF-36 dimensions "physical function" (P = 0.03) and "bodily pain" (P = 0.04) following LDN at one month postoperatively. Fatigue scores did not significantly differ between the groups at any point in time. General and physical fatigue (MFI-20) remained affected up to one year after either type of surgery. After MIDN, 4% of the donors had returned to work at four weeks postoperatively versus 28% after LDN (P = 0.04). Return to preoperative activity level was not significantly different between groups.


CONCLUSIONS
Both procedures clearly impact quality of life and fatigue. The beneficial effect on the quality of life and the earlier return to work encourage us to advocate LDN as the surgical approach to be preferred.
Kok
Niels F M
NF
Department of Surgery, Erasmus MC, Rotterdam, the Netherlands.
Alwayn
Ian P J
IP
Tran
Khe T C
KT
Hop
Wim C J
WC
Weimar
Willem
W
Ijzermans
Jan N M
JN
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005221:Fatigue / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods* / Q000523:psychology; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods* / Q000523:psychology; D011183:Postoperative Complications / Q000145:classification* / Q000503:physiopathology / Q000523:psychology; D011571:Psychoacoustics; D011788:Quality of Life; D012917:Social Adjustment; D020858:Tissue and Organ Harvesting / Q000379:methods*