Laparoendoscopic Single-Site Plus One-Port Donor Nephrectomy: Analysis of 169 Cases

J Laparoendosc Adv Surg Tech A. 2015 Aug;25(8):636-41. doi: 10.1089/lap.2014.0570. Epub 2015 Jun 1.

Abstract

Objective: To present our experience with laparoendoscopic single-site plus one-port donor nephrectomy (LESSOP-DN) and compare the outcomes with laparoscopic donor nephrectomy (LDN).

Materials and methods: Prospectively collected data from 169 consecutive LESSOP-DNs and 83 LDNs performed by a single surgeon in the same time period were analyzed retrospectively.

Results: No differences in mean operative time (136 versus 130 minutes; P=.15), warm ischemia time (3.4 versus 3.5 minutes; P=.42), blood loss (50 versus 45 mL; P=.41), transfusion rates (0 versus 1 case), hospital stay (4.0 versus 3.9 days; P=.48), or overall complication rate (12.0% versus 7.7%; P=.25) were observed between the LDN and LESSOP-DN groups. The LESSOP-DN group had a shorter time to return to 100% recovery (39 versus 74 days; P<.001), a smaller surgical incision (5.5 versus 8.2 cm; P<.001), higher scar satisfaction score (8.1 versus 6.4; P=.003), and lower analgesic requirements (79.0 versus 68.5 mg; P=.03) than the LDN group. Renal function of the recipient based on estimated glomerular filtration rate at 1 and 3 months was similar between the groups. Health-related quality of life (QOL) was significantly higher in the LESSOP-DN group in four domains of the health survey than in the LDN group.

Conclusions: LESSOP-DN might be associated with smaller surgical incision, improved cosmetic satisfaction, less time to recovery, less analgesic requirement, improved donor QOL, and equivalent recipient graft function.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Analgesics / therapeutic use
  • Blood Loss, Surgical
  • Cicatrix / etiology
  • Convalescence
  • Female
  • Humans
  • Laparoscopy / adverse effects
  • Laparoscopy / methods*
  • Length of Stay
  • Living Donors*
  • Male
  • Middle Aged
  • Nephrectomy / adverse effects
  • Nephrectomy / methods*
  • Operative Time
  • Pain, Postoperative / drug therapy
  • Pain, Postoperative / etiology
  • Quality of Life
  • Retrospective Studies
  • Tissue and Organ Harvesting / adverse effects
  • Tissue and Organ Harvesting / methods*
  • Warm Ischemia
  • Young Adult

Substances

  • Analgesics