title: Quality of life after randomization to laparoscopic versus open living donor nephrectomy: long-term follow-up.
abstract: 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.
authors.affiliation: Department of Surgery, Rikshospitalet-Radiumhospitalet Medical Centre, Oslo, Norway. marit.andersen@rikshospitalet.no
authors.forename: Marit Helen
authors.initials: MH
authors.lastname: Andersen
authors.forename: Lars
authors.initials: L
authors.lastname: Mathisen
authors.forename: Marijke
authors.initials: M
authors.lastname: Veenstra
authors.forename: Ole
authors.initials: O
authors.lastname: Oyen
authors.forename: Bjørn
authors.initials: B
authors.lastname: Edwin
authors.forename: Randi
authors.initials: R
authors.lastname: Digernes
authors.forename: Gunnvald
authors.initials: G
authors.lastname: Kvarstein
authors.forename: Tor Inge
authors.initials: TI
authors.lastname: Tønnessen
authors.forename: Astrid Klopstad
authors.initials: AK
authors.lastname: Wahl
authors.forename: Berit Rokne
authors.initials: BR
authors.lastname: Hanestad
authors.forename: Erik
authors.initials: E
authors.lastname: Fosse
mesh_terms: 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