Results and surgical complications of living donor nephrectomy: Open vs hand-assisted laparoscopic nephrectomy

Purpose. - Hand-assisted laparoscopic nephrectomy in living donors is a minimally invasive surgical modality. Laparoscopic nephrectomy is now a routine procedure. This study compares an initial group of patients undergoing laparoscopic live donor nephrectomy to a group of patients undergoing open donor. Donor morbidity and graft function in the laparoscopic group were compared with those in the open group. Materials and methods. - We retrospectively reviewed the medical records of 53 consecutive laparoscopic nephrectomy and compared them with 60 consecutive open donor nephrectomies. Results. - Demographic data of donors and recipients were similar in the two groups. No conversion to open surgery was necessary. Laparoscopic group patients had a shorter hospital stay compared to those undergoing open surgery. Long-term follow-up of serum creatinine levels revealed no significant differences among the two groups: at 3.6 and 12 months: 112 (+/- 27) versus 122 (+/- 11), 111 (+/- 25) versus 119 (+/- 19), 114 (+/- 23) versus 122 (+/- 25). There was no difference between hand-assisted laparoscopic nephrectomy (two vesico ureteral leak, three hematoma (one needed a surgical revision) and lombotomy (one vesico ureteral leak, one hematoma needed a surgical revision, two arteries stenosis). The rate of recipient ureteral stenosis in the laparoscopic and open nephrectomy groups was 0 of 39 cases and two of 60, respectively. Two vesico ureteral teak versus none appear in the lapararoscopic group. Conclusion. - Hand-assisted laparoscopic nephrectomy in living donors is a safe procedure which presented low morbidity after surgery. This provides equal graft function equal urological complications compared to open live donor nephrectomy. This is our reference method. (C) 2009 Elsevier Masson SAS. AR rights reserved.