Subcostal mini incision: a good option for donor nephrectomy.
OBJECTIVE
We describe the results of over one hundred nephrectomies performed using a subcostal mini incision.


BACKGROUND
A major effort has been undertaken to encourage living donor renal transplantation. New techniques that use minimally invasive approaches to perform donor nephrectomy have been progressively accepted. Among these new procedures is the mini-incision approach.


METHODS
We prospectively analyzed one hundred and seventeen consecutive donors that were subjected to subcostal mini-incision nephrectomy at a single center. Surgical time, warm and cold ischemia time, intraoperative complications, time until hospital discharge, presence of infection, bleeding, the need for a second operation, and death were analyzed. Eventual loss of donor renal function was indicated by increases in serum creatinine and proteinuria.


RESULTS
The mean time of surgery was 180.5 +/- 26.2 minutes. The mean warm ischemia time was 93 +/-8.3 seconds, while the mean cold ischemia time was 85.9 (+/-23.5) minutes. We had one case with an intraoperative complication, and only two patients required another operation. An intra-abdominal abscess occurred in one patient (0.85%), proteinuria occurred in one patient (0.85%), and a transitory increase of creatinine levels occurred in two patients (1.7%).


CONCLUSIONS
Reducing the length of the abdominal incision did not influence surgical time or result in an increase in intraoperative complications relative to our historical data or literature reports. Organ preparation was accomplished successfully with a brief warm ischemia time. Additionally, the mean hospital stay was short, and few surgical complications occurred.


CONCLUSIONS
The use of a subcostal mini incision is both safe and similar to conventional techniques previously described in the literature.
Department of Urology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. hkanashiro@uol.com.br
Hideki
H
Kanashiro
Renato
R
Falci
Affonso Celso
AC
Piovisan
Fernando
F
Saito
Fabio Cesar Miranda
FC
Torricelli
Willian Carlos
WC
Nahas
D000328:Adult; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D011446:Prospective Studies; D015203:Reproducibility of Results; D013997:Time Factors