Korean J Urol.  2012 Jan;53(1):54-59. 10.4111/kju.2012.53.1.54.

Complication Rates of the 720 Video-Assisted Minilaparotomy Living Donor Nephrectomies: Supplementing Clavien Classification

• Jung HB
• Choi KH
• Yang SC
• Han WK

• KMID: 1988825
• DOI: http://doi.org/10.4111/kju.2012.53.1.54

Abstract

PURPOSE
Laparoscopic living donor nephrectomy (LLDN) has been reported to be as safe and effective as open surgery. We systematically evaluated the safety of video-assisted minilaparotomy surgery-living donor nephrectomy (VAMS-LDN) with use of the modified Clavien classification.
MATERIALS AND METHODS
We retrospectively analyzed complications in 720 cases of VAMS-LDN conducted in our institute from 2003 to 2010 by use of the modified Clavien classification of surgical complications.
RESULTS
The mean age of the donors was 39.3 years (range, 16 to 66 years) and their mean body mass index was 23.3 kg/m2 (range, 15.8 to 36.4 kg/m2). A total of 67 complications occurred (9.3%). Based on the modified Clavien classification, grade 1, 2a, and 2b complications occurred in 49 (6.8%), 16 (2.2%), and 2 (0.3%) of the donors, respectively. Most grade 1 complications involved mild vascular injuries that were immediately repaired with polypropylene sutures during the surgery. These did not cause any postoperative problems. The other grade 1 complications were wound dehiscence, not requiring secondary closure, and wound site pain in 11 (1.5%) and 5 (0.7%) cases, respectively. Grade 2a complications occurred in 16 (2.2%) cases: 9 (1.3%) involved postoperative transfusions and 1 (0.1%) involved a renal fossa hematoma. One grade 2b complication occurred; it was a lymphocele that resolved with placement of a pigtail catheter. No complications classified as grade 2c or worse occurred.
CONCLUSIONS
According to the present analysis of complications, VAMS-LDN is a safe procedure with complication rates comparable to those of LLDN as evaluated in previous studies.

Keyword

Intraoperative complications; Living donors; Nephrectomy; Surgical procedures, minimally invasive

MeSH Terms

Body Mass Index
Catheters
Hematoma
Humans
Intraoperative Complications
Laparotomy
Living Donors
Lymphocele
Nephrectomy
Polypropylenes
Retrospective Studies
Surgical Procedures, Minimally Invasive
Sutures
Tissue Donors
Vascular System Injuries
Polypropylenes

Figure

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  FIG. 1 Comparison of the complications according to the surgical techniques (LDN vs. VAMS). LDN: laparoscopic donor nephrectomy, VAMS: Video-assited Minilaparotomy Surgery.

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