Retroperitoneoscopic live-donor nephrectomy: 5-year single-center experience in China.
OBJECTIVE
To evaluate the efficacy and the learning-curve period of our modified retroperitoneoscopic live-donor nephrectomy.


METHODS
From December 2003 to May 2009, 138 consecutive retroperitoneoscopic live-donor nephrectomies were carried out at our institution. Donors were separated into four groups in consecutive sequence in order to determine the learning-curve period. Groups 1-3 included forty consecutive cases each, whereas group 4 included the last eighteen cases. The renal artery and vein were controlled with two plastic locking clips at proximal ends without any clips on the kidney side. The kidney was manually retrieved through lumbar incision.


RESULTS
Mean operative times were 160.5, 116.9, 101.4 and 109.2 min in groups 1-4, respectively (group 1 vs group 2, 3 or 4, P < 0.01). Mean warm ischemic time was 3.5 min. Mean estimated blood loss was 88.8, 73.0, 69.3 and 43.9 mL in groups 1-4, respectively (group 1 vs group 4, P < 0.01). No blood transfusion or open conversion was required. Mean hospital stay was 7.8, 6.9, 6.6 and 5.8 days in groups 1-4, respectively (group 1 vs group 4, P < 0.05). Eight donors and seven grafts suffered from complications. Complication rates were 22.5%, 7.5%, 5.0% and 6.0% in groups 1-4, respectively (group 1 vs group 3, P < 0.05).


CONCLUSIONS
Our modified retroperitoneoscopic live-donor nephrectomy can be carried out safely with a learning-curve period of about 40 cases.
Ma
Lulin
L
Department of Urology, Peking University Third Hospital, Beijing, China. bysyuro@gmail.com
Ye
Jianfei
J
Huang
Yi
Y
Hou
Xiaofei
X
Zhao
Lei
L
Wang
Guoliang
G
D000328:Adult; D000368:Aged; D002681:China; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D012189:Retrospective Studies; D055815:Young Adult