Abstract
INTRODUCTION AND OBJECTIVES: Laparoendoscopic single site (LESS) surgery has been increasingly used to perform donor nephrectomies. However it remains unclear if the benefits of LESS are limited to improved cosmesis. We performed a randomized controlled trial of LESS versus conventional laparoscopic donor nephrectomy (LDN) to assess potential benefits in clinical outcomes. METHODS: After IRB approval, 100 consecutive patients were randomized to a donor nephrectomy utilizing either the LESS or LDN technique starting January 2011 at a single center. Donors were stratified by laterality, single or multiple arteries, and body mass index (BMI). All LESS procedures utilized the GelPoint system (Applied Medical, RanchoSanta Margarita, CA). Subjects are followed postdonation for complications and satisfaction with validated questionnaires at 2-, 6-, and 12-months. Ninety-three patients had follow-up data for at least 2 months postoperatively. RESULTS: Baseline characteristics were similar between the two treatment arms. There were no significant differences in the overall operative time, warm ischemia time, estimated blood loss, and conversion to hand-assisted laparoscopy rates (p 0.05). There were similarly no differences in the 30and 90-day postoperative complication rates (p 0.05). Of those with follow up of at least 2 months (n 93), 97% of those who underwent LESS reported full recovery at two months, compared to 80% of LDN (p 0.03). There were no significant differences in surgical scar rating or overall satisfaction between LESS and LDN (p 0.05). All allografts had immediate graft function, and donor and graft survival are 100% to date. CONCLUSIONS: In this randomized controlled trial, we found that LESS donor nephrectomies could be performed with similar operative outcomes and postoperative complication rates. LESS donor nephrectomies have a significantly faster recovery time compared to LDN, with no impact on allograft function. Table 1: Outcomes in LDN vs LESS
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.