Hand-assisted living-donor nephrectomy: a retrospective comparison of two techniques
Abstract Background Living-donor nephrectomy (LDN) is challenging, as surgery is performed on healthy individuals. Minimally invasive techniques for LDN have become standard in most centers. Nevertheless, numerous techniques have been described with no consensus on which is the superior approach. Bo...
Main Authors: | , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMC
2018-05-01
|
Series: | BMC Urology |
Online Access: | http://link.springer.com/article/10.1186/s12894-018-0355-2 |
id |
doaj-9172c9b4e609404abb5c607a917d36be |
---|---|
record_format |
Article |
spelling |
doaj-9172c9b4e609404abb5c607a917d36be2020-11-24T21:55:34ZengBMCBMC Urology1471-24902018-05-011811810.1186/s12894-018-0355-2Hand-assisted living-donor nephrectomy: a retrospective comparison of two techniquesJeannette D. Widmer0Andrea Schlegel1Philipp Kron2Marc Schiesser3Jens G. Brockmann4Markus K. Muller5Department of Surgery, Kantonsspital FrauenfeldDivision of Visceral and Transplantation Surgery, University HospitalDivision of Visceral and Transplantation Surgery, University HospitalDepartment of Surgery, Kantonsspital St. GallenDepartment of Surgery, Kidney and Pancreas Transplantation, King Faisal Specialist HospitalDivision of Visceral and Transplantation Surgery, University HospitalAbstract Background Living-donor nephrectomy (LDN) is challenging, as surgery is performed on healthy individuals. Minimally invasive techniques for LDN have become standard in most centers. Nevertheless, numerous techniques have been described with no consensus on which is the superior approach. Both hand-assisted retroperitoneoscopic (HARS) and hand-assisted laparoscopic (HALS) LDNs are performed at Zurich University Hospital. The aim of this study was to compare these two surgical techniques in terms of donor outcome and graft function. Method Retrospective single-center analysis of 60 consecutive LDNs (HARS n = 30; HALS n = 30) from June 2010 to May 2012, including a one-year follow-up of the recipients. Results There was no mortality in either group and little difference in the overall complication rates. Median warm ischemia time (WIT) was significantly shorter in the HARS group. The use of laxatives and the incidence of postoperative vomiting were significantly greater in the HALS group. There was no difference between right- and left-sided nephrectomies in terms of donor outcome and graft function. Conclusions Both techniques appear safe for both donors and donated organs. The HARS technique is associated with a shorter WIT and a reduced incidence of postoperative paralytic ileus. Therefore, we consider HARS LDN a valuable alternative to HALS LDN.http://link.springer.com/article/10.1186/s12894-018-0355-2 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jeannette D. Widmer Andrea Schlegel Philipp Kron Marc Schiesser Jens G. Brockmann Markus K. Muller |
spellingShingle |
Jeannette D. Widmer Andrea Schlegel Philipp Kron Marc Schiesser Jens G. Brockmann Markus K. Muller Hand-assisted living-donor nephrectomy: a retrospective comparison of two techniques BMC Urology |
author_facet |
Jeannette D. Widmer Andrea Schlegel Philipp Kron Marc Schiesser Jens G. Brockmann Markus K. Muller |
author_sort |
Jeannette D. Widmer |
title |
Hand-assisted living-donor nephrectomy: a retrospective comparison of two techniques |
title_short |
Hand-assisted living-donor nephrectomy: a retrospective comparison of two techniques |
title_full |
Hand-assisted living-donor nephrectomy: a retrospective comparison of two techniques |
title_fullStr |
Hand-assisted living-donor nephrectomy: a retrospective comparison of two techniques |
title_full_unstemmed |
Hand-assisted living-donor nephrectomy: a retrospective comparison of two techniques |
title_sort |
hand-assisted living-donor nephrectomy: a retrospective comparison of two techniques |
publisher |
BMC |
series |
BMC Urology |
issn |
1471-2490 |
publishDate |
2018-05-01 |
description |
Abstract Background Living-donor nephrectomy (LDN) is challenging, as surgery is performed on healthy individuals. Minimally invasive techniques for LDN have become standard in most centers. Nevertheless, numerous techniques have been described with no consensus on which is the superior approach. Both hand-assisted retroperitoneoscopic (HARS) and hand-assisted laparoscopic (HALS) LDNs are performed at Zurich University Hospital. The aim of this study was to compare these two surgical techniques in terms of donor outcome and graft function. Method Retrospective single-center analysis of 60 consecutive LDNs (HARS n = 30; HALS n = 30) from June 2010 to May 2012, including a one-year follow-up of the recipients. Results There was no mortality in either group and little difference in the overall complication rates. Median warm ischemia time (WIT) was significantly shorter in the HARS group. The use of laxatives and the incidence of postoperative vomiting were significantly greater in the HALS group. There was no difference between right- and left-sided nephrectomies in terms of donor outcome and graft function. Conclusions Both techniques appear safe for both donors and donated organs. The HARS technique is associated with a shorter WIT and a reduced incidence of postoperative paralytic ileus. Therefore, we consider HARS LDN a valuable alternative to HALS LDN. |
url |
http://link.springer.com/article/10.1186/s12894-018-0355-2 |
work_keys_str_mv |
AT jeannettedwidmer handassistedlivingdonornephrectomyaretrospectivecomparisonoftwotechniques AT andreaschlegel handassistedlivingdonornephrectomyaretrospectivecomparisonoftwotechniques AT philippkron handassistedlivingdonornephrectomyaretrospectivecomparisonoftwotechniques AT marcschiesser handassistedlivingdonornephrectomyaretrospectivecomparisonoftwotechniques AT jensgbrockmann handassistedlivingdonornephrectomyaretrospectivecomparisonoftwotechniques AT markuskmuller handassistedlivingdonornephrectomyaretrospectivecomparisonoftwotechniques |
_version_ |
1725861815284400128 |