title: A randomized, prospective, parallel group study of laparoscopic versus laparoendoscopic single site donor nephrectomy for kidney donation.
abstract: Few prospective, randomized studies have assessed the benefits of laparoendoscopic single site donor nephrectomy (LESS-DN) over laparoscopic donor nephrectomy (LDN). Our center initiated such a trial in January 2011, following subjects randomized to LESS-DN versus LDN from surgery through 5 years postdonation. Subjects complete recovery/satisfaction questionnaires at 2, 6 and 12 months postdonation; transplant recipient outcomes are also recorded. One hundred subjects (49 LESS-DN, 51 LDN) underwent surgery; donor demographics were similar between groups, and included a predominance of female, living-unrelated donors, mean age of 47 years who underwent left donor nephrectomy. Operative parameters (overall time, time to extraction, warm ischemia time, blood loss) were similar between groups. Conversion to hand-assist laparoscopy was required in 3 LESS-DN (6.1%) versus 2 LDN (3.9%; p = 0.67). Questionnaires revealed that 97.2% of LESS-DN versus 79.5% of LDN (p = 0.03) were 100% recovered by 2 months after donation. No significant difference was seen in satisfaction scores between the groups. Recipient outcomes were similar between groups. Our randomized trial comparing LESS donor nephrectomy to LDN confirms that LESS-DN offers a safe alternative to conventional LDN in terms of intra- and post-operative complications. LDN and LESS-DN offer similar recovery and satisfaction after donation.
authors.affiliation: Division of Transplantation Surgery, Department of Surgery, New York-Presbyterian/Weill Cornell Medical Center, New York, NY.
authors.forename: M J
authors.initials: MJ
authors.lastname: Aull
authors.forename: C
authors.initials: C
authors.lastname: Afaneh
authors.forename: M
authors.initials: M
authors.lastname: Charlton
authors.forename: D
authors.initials: D
authors.lastname: Serur
authors.forename: M
authors.initials: M
authors.lastname: Douglas
authors.forename: P J
authors.initials: PJ
authors.lastname: Christos
authors.forename: S
authors.initials: S
authors.lastname: Kapur
authors.forename: J J
authors.initials: JJ
authors.lastname: Del Pizzo
mesh_terms: D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007677:Kidney Function Tests; D016030:Kidney Transplantation; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D020858:Tissue and Organ Harvesting / Q000379:methods*
keywords: Donor nephrectomy; laparoendoscopic; minimally invasive; outcome; randomized; single site nephrectomy