title: [Comparison of the surgical approaches for nephrectomy in living related donors].
abstract: OBJECTIVE
  To compare the clinical effects and graft outcomes of 4 surgical approaches for nephrectomy in living related kidney donors.
  
  
  METHODS
  Between June, 2004 and June, 2007, 119 living related kidney donors underwent nephrectomy via different surgical approaches, and their clinical data were retrospectively analyzed. Of these donors, 22 received retroperitoneal open nephrectomy, 21 had retroperitoneoscopic nephrectomy, 13 had hand-assisted laparoscopic nephrectomy, and 63 underwent transperitoneal open nephrectomy. The operating time, warm ischemia time of the graft, renal graft artery and vein lengths, reduction rate of recipient serum creatinine in the first 3 days after renal transplantation, mean hospital stay and complications of the donors were compared between the 4 surgical approaches.
  
  
  RESULTS
  Open surgeries were associated with significantly shorter operating time (P=0.0033) and warm ischemia time of the graft (P=0.0001), longer hospital stay (P=0.0000), higher hospital expenses (P=0.0000), faster postoperative reduction of recipient serum creatinine (P=0.0001), and longer renal artery and vein lengths (P=0.0000 on the left and P=0.0001 on the right) than laparoscopic surgeries. In the laparoscopic surgery group, subcutaneous emphysema occurred in 1 case, DGF in 2 cases, and lumbar vein hemorrhage in 2 cases for which open surgery was performed. In the open surgery group, only one case required reoperation due to adrenal gland hemorrhage. All the kidney grafts were successfully harvested without other complications observed in the donors.
  
  
  CONCLUSIONS
  Both open and laparoscopic surgeries are safe for nephrectomy in living related kidney donors, and the selection of the surgical approaches depends on the kidney and donor conditions and the surgical proficiency of the surgeons.
authors.affiliation: Department of Organ Transplantation, Nangfang Hospital, Southern Medical University, Guangzhou, China. niehaibo@medmail.com.cn
authors.forename: Hai-Bo
authors.initials: HB
authors.lastname: Nie
authors.forename: Li-Xin
authors.initials: LX
authors.lastname: Yu
authors.forename: Wei-Lie
authors.initials: WL
authors.lastname: Hu
authors.forename: Xin
authors.initials: X
authors.lastname: Gao
authors.forename: Jun
authors.initials: J
authors.lastname: Lü
authors.forename: Xiao-Ming
authors.initials: XM
authors.lastname: Zhang
authors.forename: Li-Chao
authors.initials: LC
authors.lastname: Zhang
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.forename: Xiao-Fu
authors.initials: XF
authors.lastname: Qiu
authors.forename: Yuan-Song
authors.initials: YS
authors.lastname: Xiao
authors.forename: Yun-Song
authors.initials: YS
authors.lastname: Zhu
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D010535:Laparoscopy / Q000379:methods; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D012189:Retrospective Studies; D020858:Tissue and Organ Harvesting