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Related Experiment Videos

Rib resection for live-donor nephrectomy.

Muzaffer Eroğlu1, Necmettin Güvence, Ahmet Kiper

  • 1Department of Urology, SSK Ihtisas Hospital, Ankara, Turkey. docmuzer@hotmail.com

International Urology and Nephrology
|December 20, 2005
PubMed
Summary

Morbidity of living donor nephrectomy is lower with 12th rib resection compared to other methods. While 11th rib resection offers shorter operation times, it leads to increased pain. Subcostal incisions present a higher risk of incisional hernia.

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Area of Science:

  • Nephrology
  • Surgical Techniques
  • Transplantation

Background:

  • Living-related kidney transplants offer superior outcomes compared to cadaveric transplants.
  • Standard donor nephrectomy techniques include subcostal incision or 11th/12th rib resection.
  • Laparoscopic donor nephrectomy is an emerging, popular alternative.

Purpose of the Study:

  • To evaluate the morbidity associated with different rib resection techniques in living donor nephrectomy.
  • To compare the outcomes of 11th rib resection, 12th rib resection, and subcostal incision.

Main Methods:

  • A retrospective study of 103 living donor nephrectomies performed between 1997 and 2004.
  • Patients were divided into three groups: 11th rib resection (30), 12th rib resection (52), and subcostal incision (21).

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  • Outcomes analyzed included operation time, pleural/peritoneal defects, pneumothorax, transfusion needs, wound infection, hospital stay, analgesic requirement, return to activities, and incisional hernia.

    • Main Results:

    • 11th rib resection group had the shortest operation time but experienced prolonged postoperative pain.
    • Subcostal incision group had the highest incidence of incisional hernia (19%).
    • No significant differences were observed in wound infection, pneumothorax, blood transfusion, or return to daily activities across groups.

    Conclusions:

    • Morbidity was lowest in the 12th rib resection group for living donor nephrectomy.
    • 11th rib resection should be considered for specific anatomical cases, such as high-lying kidneys or upper pole polar arteries.
    • 12th rib resection appears to be a favorable surgical approach regarding patient morbidity.