Publication: Comparison of Outcomes of Open versus Laparoscopic Living Donor Nephrectomy in Nepal
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Date
2020
Journal Title
Journal ISSN
Volume Title
Publisher
Institute of Medicine
Abstract
ABSTRACT
Introduction: Laparoscopic donor nephrectomy is the gold standard for kidney retrieval in live donors. Until recently, donor nephrectomies were performed only by open technique in Nepal. There is no information on the experience and outcomes of laparoscopic donor nephrectomy in Nepal. The study was done to compare the outcomes among donors undergoing open and laparoscopic nephrectomies, and to compare the graft related outcomes between the two groups receiving these kidneys.
Methods: In this retrospective study, 44 kidney donors from March 2019 to October 2019 were analyzed. Donors were divided into 2 groups: open donor nephrectomy (ODN) and laparoscopic donor nephrectomy (LDN). Parameters for analysis included demographic data, warm ischemia time, surgery time and length of hospital stay. Data on early graft function and complications in recipients till 30th post-operative day were compared.
Results: There were 22 donors each in the ODN and LDN groups. Baseline characteristics of the donors were comparable between two groups. Mean surgery duration (183.55±43.31 minutes vs 117.73±18.75 minutes) and first warm ischemia time (11.22±4.34 minutes vs 2.3±0.8 minutes) was significantly high in LDN. Hemoglobin drop, post-operative complications in donors, creatinine of donors at discharge, mean hospital stay, graft function at one month and complications in recipients were comparable among ODN and LDN. Pain score in 1st post-operative day was comparable between two groups, however, pain was significantly less in second post-operative day in LDN.
Conclusion: Laparoscopic donor nephrectomy is feasible in Nepal and associated with acceptable morbidity and graft function when compared to ODN.
Keywords: Laparoscopic donor nephrectomy, open donor nephrectomy, renal transplantation
Description
Prem R Sigdel1, Diwas Gnyawali1, Bipendra D K Rai1, Pawan Dhital1, Purushottam Parajuli1, Sampanna Chudal1, Niraj Dhakal2, Manish Pradhan1, Sujeet Poudyal1, Suman Chapagain1, Bhoj R Luitel1, Pawan R Chalise1, Uttam K Sharma1, Prem R Gyawali1
1Department of Urology and Kidney Transplant Surgery
2Department of Nephrology, Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
Keywords
Laparoscopic donor nephrectomy, open donor nephrectomy, renal transplantation