Option of minimally invasive technique for living donor nephrectomy / 中华泌尿外科杂志

ABSTRACT

Objective To discuss the optimal operation mode and operation path in minimally invasive technique for living donor nephrectomy.Methods From September 2013 to August 2015, 68 living donor nephrectomy was retrospectively reviewed. Thirty-one patients were performed with robotic-assisted laparoscopic living donor nephrectomy(robotic group), twenty-nine patients underwent totally retroperitoneal laparoscopic living donor nephrectomy(non hand assisted group),and eight patients were performed with hand assisted retroperitoneal laparoscopic living donor nephrectomy(hand assisted group). Operation time, warm ischemia time, intraoperative hemorrhage volume, hospitalization time, complications and preoperative and postoperative serum creatinine value of the recipients between the two groups were compared.Results The operations of three groups were all performed successfully. Intraoperative hemorrhage volume in the three groups were(39±15)ml,(62±37)ml and(53±19)ml, and there were significant differences between these groups(P<0.05). But hospitalization time ,operation time, warm ischemia time and complications occurred rate in the three groups had no significant difference(P>0.05). In robotic group,2 donors occurred with splenic injury during operation and 1 donor was detected with hemorrhage after operation. In non-hand assisted group, 1 donor occurred with urinary tract infection, 1 donor occurred with external iliac vein thrombosis. In hand assisted group 1 donor was detected with wound fat liquefaction after operation. All the donors were followed up for more than 9 months, no hypertension, proteinuria and renal dysfunction complications were detected. The blood creatinine in three groups of recipients after operation of 5th day and 28th day were(118±26)μmol/L, (130±33)μmol/L,(128±41)μmol/L and(114±17)μmol/L,(116±34)μmol/L,(115±29)μmol/L, respectively, and there was no statistical difference(P>0.05).Conclusions Minimally invasive technique for living donor nephrectomy is beneficial to patients' recovery. Surgery doctors should combine personal experience and the hospital's hardware conditions and other factors. The principle is to ensure the donor's safety and to balance the interests of the donor and the recipient, to choose their own most skilled way of surgery.