title: Comparison of laparoendoscopic single-site donor nephrectomy and conventional laparoscopic donor nephrectomy: donor and recipient outcomes.
abstract: OBJECTIVE
  To present a comparison of perioperative donor outcomes and recipient graft function in a series of patients undergoing laparoendoscopic single-site donor nephrectomy (LESS-DN) versus conventional laparoscopic donor nephrectomy (LDN).
  
  
  METHODS
  Data were collected for 50 consecutive LESS-DN patients and a matched cohort of 50 LDN patients. The donor outcomes analyzed included operative time, estimated blood loss, complications, visual analog pain scores, and recovery time. The recipient outcomes analyzed included serum creatinine at discharge and follow-up and the incidence of delayed graft function.
  
  
  RESULTS
  The mean total operative time was shorter in the LDN group than in the LESS-DN group (P < .0001). Linear regression analysis of the LESS-DN operative times relative to case number showed a significant decrease in the operative time with increasing case number (r(2) = 0.19, P = .002). No statistically significant differences were found in estimated blood loss, warm ischemia time, length of stay, or visual analog pain scores between the 2 groups. However, the surgical incision was significantly smaller in the LESS-DN group (P < .0001). After discharge, the patient-reported time to complete recovery was faster in the LESS-DN group (P = .01). The incidence of complications was similar in both groups; however, major complications only occurred in the LDN group. No differences were found in the recipient serum creatinine values or the incidence of delayed graft function.
  
  
  CONCLUSIONS
  Our initial experience with LESS-DN is encouraging. This retrospective matched-pair comparison between LESS-DN and LDN suggests that the single-port approach might be associated with quicker convalescence. Longer operative times in the LESS-DN group could simply represent the learning curve of a novel procedure.
authors: Department of Surgery, Division of Transplantation Surgery, New York Presbyterian Weill Cornell Medical College, New York, New York 10021, USA.
authors: Cheguevara
authors: C
authors: Afaneh
authors: Meredith J
authors: MJ
authors: Aull
authors: Elena
authors: E
authors: Gimenez
authors: Gerald
authors: G
authors: Wang
authors: Marian
authors: M
authors: Charlton
authors: David B
authors: DB
authors: Leeser
authors: Sandip
authors: S
authors: Kapur
authors: Joseph J
authors: JJ
authors: Del Pizzo
mesh_terms: D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D016063:Blood Loss, Surgical; D003289:Convalescence; D003404:Creatinine / Q000097:blood; D051799:Delayed Graft Function / Q000209:etiology; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects / Q000379:methods*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D016014:Linear Models; D019520:Living Donors; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D052096:Warm Ischemia
chemical_list: D000700:Analgesics; D003404:Creatinine