MP37-20 COMPARISON OF CLINICAL OUTCOME, SURGICAL INVASIVENESS, AND COSMETIC RESULTS OF CONVENTIONAL LAPAROSCOPIC SURGERY AND REDUCED-PORT SURGERY FOR LIVING DONOR NEPHRECTOMY

Abstract

You have accessJournal of UrologyRenal Transplantation & Vascular Surgery I (MP37)1 Sep 2021MP37-20 COMPARISON OF CLINICAL OUTCOME, SURGICAL INVASIVENESS, AND COSMETIC RESULTS OF CONVENTIONAL LAPAROSCOPIC SURGERY AND REDUCED-PORT SURGERY FOR LIVING DONOR NEPHRECTOMY Mitsuru Saito, Shintaro Narita, Kazuyuki Numakura, Taketoshi Nara, Atsushi Koizumi, Ryohei Yamamoto, Soki Kashima, Shigeru Satoh, and Tomonori Habuchi Mitsuru SaitoMitsuru Saito More articles by this author , Shintaro NaritaShintaro Narita More articles by this author , Kazuyuki NumakuraKazuyuki Numakura More articles by this author , Taketoshi NaraTaketoshi Nara More articles by this author , Atsushi KoizumiAtsushi Koizumi More articles by this author , Ryohei YamamotoRyohei Yamamoto More articles by this author , Soki KashimaSoki Kashima More articles by this author , Shigeru SatohShigeru Satoh More articles by this author , and Tomonori HabuchiTomonori Habuchi More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002046.20AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Reduced-port surgery (RPS) for living donor nephrectomy (LDN) is challenging. Whether RPS is less invasive than conventional laparoscopic surgery (CLS) using several ports is unclear. LDN is an optimal model for evaluating surgical invasiveness by measurement of circulating inflammatory cytokine levels, because renal transplant donors are not affected by disease status. In this study, we compared the clinical outcome, surgical invasiveness, and cosmetic results of CLS and RPS for LDN. METHODS: We enrolled 137 donors (the CLS group; 64, and the RPS group; 73) who underwent LDN in our hospital. The RPS group included 41 donors undergoing single-port surgery (SPS) and 32 donors undergoing surgery through a single port plus one additional 5-mm port. Evaluation of both surgical techniques included comparison of conventional clinical parameters and preoperative, immediate postoperative, and 1-day postoperative levels of the following circulating inflammatory cytokines; tumor necrosis factor (TNF)-α, interleukin (IL)-1b, IL-6, IL-8, IL-10, and IL-12p70. More than 1 year after surgery, cosmetic results were assessed for all donors by the Patient Scar Assessment Questionnaire (PSAQ). RESULTS: The frequency of performance of right nephrectomy was significantly lower in the RPS group than in the CLS group (6/64 vs. 1/73, p=0.03). Other clinical parameters in the RPS group, including the frequency of surgical complications and incidence of delayed graft function, were comparable to those in the CLS group. The immediate and 1-day postoperative mean serum IL-10 levels were significantly higher in the CLS group than in the RPS group (p<0.001 for both days). The 1-day postoperative mean serum TNF-α (p=0.02) and IL-8 (p=0.01) levels were also significantly higher in the CLS group than in the RPS group. The mean serum IL-10, TNF-α, and IL-8 levels were not associated with IL-6 levels, duration of surgery, or estimated intraoperative blood loss. Among young and middle-aged women, PSAQ scores indicated that donors undergoing RPS were significantly more satisfied with the cosmetic results than were donors undergoing CLS. CONCLUSIONS: There were no significant differences between the results of the two surgical techniques for LDN in conventional clinical parameters related to surgical invasiveness. Although the inflammatory cytokine response suggested that RPS was less invasive than CLS, the clinical outcome indicates that the two techniques were equally effective as minimally invasive surgeries. Young and middle-aged woman donors were more satisfied with the cosmetic results of RPS than with those of CLS. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e654-e654 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mitsuru Saito More articles by this author Shintaro Narita More articles by this author Kazuyuki Numakura More articles by this author Taketoshi Nara More articles by this author Atsushi Koizumi More articles by this author Ryohei Yamamoto More articles by this author Soki Kashima More articles by this author Shigeru Satoh More articles by this author Tomonori Habuchi More articles by this author Expand All Advertisement Loading ...