Comparison of Laparoscopic and Open Live Donor Nephrectomy

Syed Daood Hashmi; Sohail Razik; Majid Aziz; Muhammad Naeem; Muhammad  Ali; Bilal Saeed

doi:10.51253/pafmj.v75iSUPPL-5.12109

Authors

Syed Daood Hashmi Department of General Surgery, Armed Forces Institute of Urology, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Sohail Razik Department of General Surgery, Armed Forces Institute of Urology, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Majid Aziz Department of General Surgery, Pak Emirates Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Muhammad Naeem Department of General Surgery, Armed Forces Institute of Urology, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Muhammad Ali Department of General Surgery, Armed Forces Institute of Urology, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Bilal Saeed Department of General Surgery, Armed Forces Institute of Urology, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v75iSUPPL-5.12109

Keywords:

Kidney Transplant, Laparoscopic Live Donor Nephrectomy, Open Live Donor Nephrectomy

Abstract

Objective: To compare laparoscopic live donor nephrectomy with open live donor nephrectomy.

Study Design: Cross Sectional Analytical Study.

Place and Duration of study: Armed Forces Institute of Urology, from May 2023 to Apr 2024

Methodology: With non-probability consecutive sampling technique, the patients who presented in OPD between May 2023 and April 2024 and underwent live donor nephrectomy were selected by non-convenience sampling technique. The kidney donors were divided into two groups: Group A -those scheduled for open donor nephrectomy and Group B - those receiving laparoscopic donor nephrectomy.

Results: There were 22 donors each group. The donors' ages varied from 36 to 59 years, with an average age of 47.75+5.29 years. In the participating group were thirty males and fourteen females. Study involved the performance of 7 right-sided donor nephrectomies (RDN) and 37 left-sided donor nephrectomies (LDN). In cases with Group B, the average length of the procedure was noticeably longer. Furthermore, the initial warm ischemia in Group B - lasted an average of 9.43 + 1.93 minutes, a significantly longer time than in Group A (4.04+1.21 minutes). It was determined that this difference was statistically significant.

Conclusion: Our study concluded that laparoscopic donor nephrectomy showed advantages including less discomfort after surgery, a faster recovery period, and comparable results for graft function when compared to open live donor nephrectomy. These results imply that laparoscopic donor nephrectomy is a practical and well-liked procedure, which adds to its growing acceptance in the medical community.

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References

1. Harrison S. GIRFT programme national specialty report. NHS Improvement, July 2018 Jul.

2. Bhattu AS, Ganpule A, Sabnis RB. Robot-assisted laparoscopic donor nephrectomy vs. standard laparoscopic donor nephrectomy: A prospective randomized comparative study. J Endourol 2015; 2: 1334–40.

https://doi.org/10.12659/AOT.918189

3. Zacharis A, Reimold P, Aksoy C, Jung J, Martin T, Eisenmenger N et al. Trends in kidney transplantation and living donor nephrectomy in Germany: a total population analysis from 2006 to 2021. World Journal of Urology 2024; 42(1): 24.

https://doi.org/ 10.1007/s00345-023-04737-w

4. Achit H, Guillemin F, Karam G, Ladrière M, Baumann C, Frimat L, Hosseini K, Hubert J. Cost-effectiveness of four living-donor nephrectomy techniques from a hospital perspective. Nephrology Dialysis Transplantation 2020; 35(11): 2004-12.

https://doi.org/ 10.1093/ndt/gfz143

5. Wang L, Zhu L, Xie X, Wang H, Yin H, Fang C, Dai H. Long-term outcomes of laparoscopic versus open donor nephrectomy for kidney transplantation: a meta-analysis. American journal of translational research 2020; 12(10): 5993.

6. Thuluvath AJ, Peipert J, Berkowitz R. Donor quality of life after living donor liver transplantation: A review of the literature. Dig Med Res 2021; 4: 49. https://doi.org/ 10.21037/dmr-20-151

7. Siddique SH, Mithani MS, El Khalid S, Wasay A, Ullah H, Zafar Z, Khan SA. Surgical complications and long term follow up of live related kidney donors, encountered with open donor nephrectomy: Single Center Study in Pakistan. Pakistan Journal of Medical & Health Sciences. 2022; 16(02): 1156. https://doi.org/ 10.53350/pjmhs221621156

8. Sigdel PR. Comparison of Outcomes of Open versus Laparoscopic Living Donor Nephrectomy in Nepal. Journal of Institute of Medicine Nepal (JIOM Nepal) 2020; 42(1): 31-35.

9. Gill J, Joffres Y, Rose C. The Change in Living Kidney Donation in Women and Men in the United States (2005–2015): A Population-Based Analysis. Journal of the American Society of Nephrology 2018 https://doi.org/ 10.1681/ASN.2017111160

10. Baranski A. Non-Laparoscopic Kidney Procurement Techniques from Living and Deceased Donors. InKidney Transplantation: Step-by-Step Surgical Techniques 2023 Apr 27 (pp. 33-130). Cham: Springer International Publishing.

11. Taweemonkongsap T, Nualyong C, Amornvesukit T. Laparoscopic live-donor nephrectomy: a comparison with the open technique and how to reach quality standards: a singlecenter experience in Thailand. Transplantation proceedings. 2011; 43(10): 3593-3598.

https://doi.org/ 10.1016/j.transproceed.2011.08.115

12. Waller JR, Hiley AL, Mullin EJ. Living kidney donation: a comparison of laparoscopic and conventional open operations. Postgraduate Medical Journal. 2002; 78(917): 153-15`+7. https://doi.org/ 10.1136/pmj.78.917.15311

13. Jacobs SC, Cho E, Dunkin BJ. Laparoscopic nephrectomy in the markedly obese living renal donor. Urology 2000; 56(6): 926-929. https://doi.org/ 10.1016/s0090-4295(00)00813-x

14. Mandal AK, Cohen C, Montgomery RA. Should the indications for laparascopic live donor nephrectomy of the right kidney be the same as for the open procedure? Anomalous left renal vasculature is not a contraindiction to laparoscopic left donor nephrectomy. Transplantation 2001; 71(5): 660-664. https://doi.org/ 10.1097/00007890-200103150-00015

15. Lennerling A, Blohme I, Ostraat O. Laparoscopic or open surgery for livingdonor nephrectomy. Nephrology, dialysis, transplantation: official publication of the European Dialysis and Transplant Association - European Renal Association 2001; 16(2): 383-386.

https://doi.org/ 10.1093/ndt/16.2.383

16. Mohsin R, Shehzad A, Bajracharya U. Laparoscopic Donor Nephrectomy: Early Experience at a Single Center in Pakistan. Experimental and clinical transplantation: official journal of the Middle East Society for Organ Transplantation. 2018; 16(2): 138-42. https://doi.org/ 10.6002/ect.2016.0333

17. Zaytoun O, Elsawy M, Ateba K, Khalifa A, Hamdy A, Mostafa A et al. Laparoscopic donor nephrectomy: technique and outcome, a single-center experience. African Journal of Urology 2021; 27(1): 1-6. https://doi.org/10.1186/s12301-021-00254-7

18. Andersen MH, Mathisen L, Øyen O. Postoperative Pain and Convalescence in Living Kidney Donors—Laparoscopic Versus Open Donor Nephrectomy: A Randomized Study. American Journal of Transplantation 2006; 6(6): 1438-43.

https://doi.org/ 10.1111/j.1600-6143.2006.01301.x

19. Sozener U. Laparoscopic live donor nephrectomy: single-center experience of 200 consecutive cases. Journal of Laparoendoscopic & Advanced Surgical Techniques 2021; 31(6): 627-31. https://doi.org/ 10.1089/lap.2020.0545

20. Saifee Y, Bhatia S, Chamania CS, Salgia P, Kriplani J, Sepaha A et al. Introduction of laparoscopic donor nephrectomy: challenges, outcomes and success strategies. International Journal of Organ Transplantation Medicine 2021; 12(1): 23.