Quality of life after randomization to laparoscopic versus open living donor nephrectomy: long-term follow-up.
BACKGROUND
The aim of this randomized study was to compare patient-reported outcome after laparoscopic versus open donor nephrectomy during 1 year follow-up. The evidence base has so far not allowed for a decision as to which method is superior as seen from a long-term quality of life-perspective.


METHODS
The donors were randomized to laparoscopic (n=63) or open (n=59) nephrectomy, with follow-up at 1, 6, and 12 months. Primary outcomes were health status (SF-36) and overall quality of life (QOLS-N). Secondary outcomes were donor perception of the surgical scar, the donation's impact on personal finances, and whether the donor would make the same decision to donate again.


RESULTS
There was a significant difference in favor of laparoscopic surgery regarding the SF-36 subscale bodily pain at 1 month postoperatively (P<0.05). Analysis based on intention to treat revealed no long-term differences between groups in SF-36 scores. When subtracting the reoperated/converted donors of the laparoscopic group, significant differences in favor of laparoscopy were revealed in the subscales bodily pain at 6 months (P<0.05) and social functioning at 12 months (P<0.05). No significant differences were found in QOLS-N scores between groups.


CONCLUSIONS
Laparoscopic donor nephrectomy is an attractive alternative to open donor nephrectomy because of less postoperative pain. However, long-term comparison only revealed significant differences in favor of laparoscopy when adjusting for reoperations/conversions. Both groups reached baseline scores in most SF-36 subscales at 12 months and this may explain why possible minor benefits are hard to prove.
Andersen
Marit Helen
MH
Department of Surgery, Rikshospitalet-Radiumhospitalet Medical Centre, Oslo, Norway. marit.andersen@rikshospitalet.no
Mathisen
Lars
L
Veenstra
Marijke
M
Oyen
Ole
O
Edwin
Bjørn
B
Digernes
Randi
R
Kvarstein
Gunnvald
G
Tønnessen
Tor Inge
TI
Wahl
Astrid Klopstad
AK
Hanestad
Berit Rokne
BR
Fosse
Erik
E
D000328:Adult; D005260:Female; D006304:Health Status; D006801:Humans; D007398:Interpersonal Relations; D010535:Laparoscopy; D019520:Living Donors; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D010149:Postoperative Pain / Q000503:physiopathology; D011184:Postoperative Period; D011788:Quality of Life; D013997:Time Factors