Retroperitoneoscopic donor nephrectomy: donor outcome and complication rate in comparison with three different...

Area of Science:

• Nephrology
• Surgical Innovation
• Transplantation Surgery

Background:

• Living donor nephrectomy is crucial for kidney transplantation.
• Minimally invasive techniques aim to improve donor outcomes.
• Comparative analysis of different surgical approaches is essential.

Purpose of the Study:

• To retrospectively analyze perioperative outcomes and early complication rates of four living donor nephrectomy techniques.
• To compare open (OLDN), fully laparoscopic (LDN), hand-assisted laparoscopic (HLDN), and retroperitoneoscopic (RLDN) donor nephrectomies.
• To identify the most efficient and safe surgical method for living kidney donation.

Main Methods:

• Retrospective analysis of 182 living donor nephrectomies.
• Categorization into Open (OLDN), Laparoscopic (LDN), Hand-Assisted Laparoscopic (HLDN), and Retroperitoneoscopic (RLDN) groups.
• Comparison of operating time (OPT) and warm ischemia time (WIT), and complication rates.

Main Results:

• Significant differences in mean operating time (OPT) were observed: OLDN (160 min) and RLDN (150 min) were shorter than LDN (212 min) and HLDN (192 min).
• Mean warm ischemia time (WIT) was significantly shorter for OLDN (114 s), RLDN (121 s), and HLDN (128 s) compared to LDN (238 s).
• Major complication rates were comparable across all four surgical techniques.

Conclusions:

• Retroperitoneoscopic donor nephrectomy (RLDN) offers comparable operating time and warm ischemia time to open donor nephrectomy (OLDN).
• Fully laparoscopic donor nephrectomy (LDN) is associated with significantly longer operating times and warm ischemia times.
• While major complication rates are similar, learning endoscopic donor nephrectomy may initially involve a higher complication risk.