The Comparison of Hand-assisted Laparoscopic Donor Nephrectomy with Open Donor Nephrectomy

Han, Deok Hyun; Chung, Kyung Jin; Ryu, Sung Ho; Lee, Joo Hwan; Lee, Sung Won

Abstract

PURPOSE: Despite its minimal invasiveness, the application of standard laparoscopic donor nephrectomy has been limited by technical difficulty and the concern for the prolongation of the warm ischemic and operation times. Our experience of hand-assisted laparoscopic donor nephrectomy (HALDN) is reported and compare with that of an open donor nephrectomy (ODN).
MATERIALS AND METHODS
28 patients underwent a HALDN of the left kidney at our institution. During the same period, 31 patients underwent an ODN of the left kidney by the same surgeon. To compare HALDN with ODN, the operation time, estimated blood loss (EBL), hematocrit difference between pre- and post-operation (delta Hct), warm ischemic time, periods of time to resume diet and to remove drain, hospital stay, complications and graft function and survival were evaluated.
RESULTS
The HALDN patients had similar mean operation and warm ischemic times to those undergoing ODN (189 versus 182 minutes and 2.0 versus 1.7 minutes, respectively). The mean hospital stay was shorter for the HALDN than the ODN patients (5.5 versus 6.9 days, p<0.05). There were no significant differences between the patients undergoing HALDN and ODN in terms of the EBL, deltaHct, and times to resume diet and to the remove drain and complications. Two of the HALDN and four of the ODN patients experienced acute rejection. The graft survivals were 100 and 96.8% in the HALDN and ODN, respectively. There was no significant difference in the allograft functions between the HALDN and ODN groups.
CONCLUSIONS
A HALDN is technically feasible, has the benefit of minimal invasiveness and can reduce the potential graft damage by minimizing the operation and warm ischemic times. Therefore, HALDN seems to be a favorable option for live donor nephrectomy.