Minimally Invasive and Open Donor Nephrectomy: Lessons Learned From a French Multicenter Experience |
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| Affiliation: | 1. Department of Urology, University Hospital, Nancy, France;2. Division of Urology, University of São Paulo, São Paulo, Brazil;3. Clinical Epidemiology Center CIC 1433 Inserm, University Hospital, Nancy, France;4. University Hospital, Site Hôtel-Dieu, Nantes, France;5. Department of Nephrology, University Hospital, Nancy, France;6. IADI-UL-INSERM (U1254), University Hospital, Nancy, France;1. Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil;2. Laboratory of Medical Investigation 37 (LIM-37), Faculdade de Medicina da Universidade de São Paulo (FMUSP), Sao Paulo, Brazil;3. Kidney Transplantation Division, Department of Urology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil;1. Division of Cardiac Surgery, IRCCS, Azienda Ospedaliero-Universitaria di Bologna Policlinico di S. Orsola, Alma Mater Studiorum, University of Bologna, Bologna, Italy;2. Division of Cardiology, IRCCS, Azienda Ospedaliero-Universitaria di Bologna Policlinico di S. Orsola, Alma Mater Studiorum, University of Bologna, Bologna, Italy;1. Department of Medicine, Cleveland Clinic, Cleveland, Ohio;2. Department of Medicine, University of Missouri, Kansas City, Missouri;3. Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio;1. Department of Pharmacy, Sentara Norfolk General Hospital, Norfolk, Virginia;2. Sound Physicians, Richmond Community Hospital, Richmond, Virginia;3. Division of Nephrology, Eastern Virginia Medical School, Norfolk, Virginia;4. Department of Surgery, Sentara Norfolk General Hospital, Norfolk, Virginia;5. Kidney/Pancreas Transplant Department, Sentara Norfolk General Hospital, Norfolk, Virginia;6. Transplant Department, Children''s Hospital of the King''s Daughters, Norfolk, Virginia;7. Tidewater Kidney Specialists, Norfolk, Virginia;1. Department of Medical Pharmacology, Biruni University School of Medicine, Istanbul, Turkey;2. Department of Obstetrics and Gynecology, Biruni University School of Medicine, Istanbul, Turkey;3. Department of Obstetrics and Gynecology, Medicana International Istanbul Hospital, Istanbul, Turkey |
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| Abstract: | BackgroundWe evaluated different techniques of donor nephrectomy.MethodsOutcomes of 4 surgical approaches (open surgery [OS], standard laparoscopy [SL], hand-assisted laparoscopy [HAL], and robot-assisted la`paroscopy [RAL]) were compared.ResultsA total of 264 nephrectomies were performed: 65 in the OS group, 65 in the SL group, 65 in the HAL group, and 69 in RAL group. Operative time was longer for the RAL group (P < .001) with a mean time of 202 minutes (RAL), 182 minutes (OS), 173 minutes (SL), and 157 minutes (HAL). Complications (P = .002) and consumption of morphine derivates (P = .31) were lower for the RAL group (P = .0002). The visual analog scale pain scores (P = .002), hospital stay (P = .023), and time to return to full activities (P = .79) were higher for OS.ConclusionsThe 4 different nephrectomy surgical approaches had similar favorable results. The robot-assisted technique presented as an alternative option, with low incidence of complications, less pain, and results comparable to the other techniques. |
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