Hand-assisted and pure laparoscopic living donor nephrectomy: a matched-cohort comparison over 10 yr at a single institute.

Choi, Sae Woong; Kim, Kang Sup; Kim, Seol; Choi, Yong Sun; Bae, Woong Jin; Hong, Sung-Hoo; Lee, Ji Youl; Kim, Sae Woong; Hwang, Tae-Kon; Cho, Hyuk Jin

OBJECTIVE To compare outcomes between matched patients who underwent hand-assisted laparoscopic donor nephrectomy (HALDN) and pure laparoscopic donor nephrectomy (PLDN) from living donors. METHOD Between February 2000 and July 2012, 608 consecutive patients underwent laparoscopic living donor nephrectomy at a single center. In September 2003, we began to perform the PLDN for the first time. A matched-pair cohort of 80 patients who underwent PLDN and 80 patients who underwent HALDN was selected for retrospective comparison. RESULT No significant differences in operative time, warm ischemia time, estimated blood loss, transfusion rate, analgesic requirement, or hospital stay were observed between the HALDN and PLDN groups. No differences were found in the recipient serum creatinine values (mg/dL) and estimated glomerular filtration rate by the Modification of Diet in Renal Disease (MDRD-eGFR; mL/min/1.73 m(2) ). CONCLUSION No significant differences were observed in surgical outcomes, complication rates, and postoperative parameters between the HALDN and PLDN groups. Moreover, recipient graft function and morbidity between both groups were comparable. Therefore, we believe that PLDN may be a good alternative technique to HALDN.