Comparison Of Safety And Effectiveness Between Different Methods Of Living Donor Nephrectomy

PurposeAt present,open live donor nephrectomy(ODN),laparoscopic live donor nephrectomy(LDN)and robotic-assisted laparoscopic nephrectomy(RLDN)are the three major kinds of surgical methods of living donor nephrectomy.The application of ODN and LDN was earlier,and was widely used in china and abroad.As a new surgical approach,RLDN is used less than the previous two in our country.This study was conducted to summarize the safety and effectiveness of live donor nephrectomy and compare RLDN?LDN and ODN.MethodsFrom January 2010 to March 2016,44 cases were hospitalized for living donor nephrectomy and their data was analyzed retrospectively,with 5 cases who underwent RLDN,11 cases who underwent LDN,and 28 cases who underwent ODN.We recorded the clinical,imaging and postoperative follow-up data of all cases.We analyzed various data of three groups by analysis of variance and chi-square tests.ResultsBoth of the three groups were performed successfully without any intraoperative complications.Warm ischemia time of RLDN(178 ± 19.24 s),LDN(164.09 ± 24.58 s)was shorter than ODN(40.36 ± 9.99 s),(P=0.000,P=0.000).Absolute bedtime of RLDN(31.6±2.41 h),LDN(34.36±6.04 h)was shorter than ODN(41.46+11.120 h),(P=0.039,P=0.043).Hospitalization time of RLDN,LDN and ODN were(5.6±0.55)days,(9.27±2.37)days,(9.71±2.28)days,which showed hospitalization time of RLDN was shorter than LDN and ODN(P=0.001,P=0.003).Lengths of surgical incision was shorter in RLDN(7.8 ± 0.84cm)and LDN(8.55 ± 1.04cm)than ODN(17.46± 1.6cm),(P=0.000,P=0.001).And days of donor analgesic requirement was shorter in RLDN(3.2± 0.84 d)and LDN(4.64 ± 1.36 d)than ODN(8.61 ± 2.01 d),(P=0.003,P=0.001).However,there's no statistically significant difference between the three groups regarding operation time,intraoperative hemorrhage volume,incidence of complications and diet time(P>0.05).All the donors had no problems with life and work.None of the kidney occurred with delayed graft function.ConclusionsRLDN and LDN are as safe and feasible as ODN.Laparoscopic surgery especially robotic-assisted laparoscopic surgery possesses the advantage of small trauma,less pain,inapparent scars and rapid recovery.Which can lessen the burden placed on living donors.