[Results and surgical complications of living donor nephrectomy: open vs hand-assisted laparoscopic nephrectomy]. / Résultats et complications chirurgicales de la néphrectomie donneur vivant : lombotomie vs laparoscopie manuellement assistée.

ABSTRACT

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 leak 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.