Randomized trial of laparoscopic donor nephrectomy with and without hand assistance

Vladislav Bargman, Chandru Sundaram, Jonathan Bernie, William Goggins

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

Purpose: To compare the early results of standard laparoscopic (SL) and hand-assisted laparoscopic (HAL) donor nephrectomy in a randomized study. Patients and Methods: Forty donors were randomly assigned in equal numbers to either SL or HAL. Two donors in the SL group and three patients in the HAL group underwent right nephrectomy; the others underwent left nephrectomy. In the SL group, specimen extraction was performed via a Pfannenstiel incision and in HAL group through a periumbilical midline incision. Objective intraoperative, hospital stay, and postoperative data as well as pain analog scores were collected prospectively. Patients completed the quality-of-life (QoL) SF-36 questionnaire preoperatively and at 1 month and 3 months of follow-up. Results: There was a statistically significant difference in the mean operative time in the two groups (200 ± 20.8 minutes for SL v 219 ± 28.3 minutes for HAL; P = 0.02). There was no difference in the mean estimated blood loss (141.5 ± 221.8 mL v 97.4 ± 73 mL, respectively; P = 0.41), warm ischemia time (157.5 ± 76.3 seconds v 135.5 ± 53.7 seconds; P = 0.32), length of postoperative hospital stay (1.9 ± 0.5 days v 2.1 ± 0.5 days; P = 0.61), intravenous analgesia (22.1 ± 14.0 mg v 28.3 ± 14.8 mg of morphine sulfate equivalent; P = 0.18), or pain score on postoperative day 1 (6.1 ± 1.0 v 6.2 ± 1.1) and 2 (3.3 ± 1.2 and 3.4 ± 1.3). There were five minor complications in the SL group and three in the HAL group. The mean preoperative (89.7 ± 4.8 v 89.2 ± 7.4; P = 0.84), 1-month (63.4 ± 13.9 v 64,5 ± 12.6; P = 0.82), and 3-month (82.7 ± 7.4 v 80.2 ± 8.4; P = 0.41) postoperative QoL scores did not differ significantly between the groups. None of the recipients required postoperative dialysis, and there was no statistical difference between the two groups in the serum creatinine concentration. Conclusion: Laparoscopic and hand-assisted donor nephrectomies have similar outcomes and postoperative pain. Both approaches are well tolerated with minimal complication rates and have similar impact on patients' quality of life.

Original languageEnglish
Pages (from-to)717-722
Number of pages6
JournalJournal of Endourology
Volume20
Issue number10
DOIs
StatePublished - Oct 2006

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Nephrectomy
Hand
Tissue Donors
Quality of Life
Length of Stay
Warm Ischemia
Pain
Operative Time
Postoperative Pain
Analgesia
Morphine
Dialysis
Creatinine
Serum

ASJC Scopus subject areas

  • Urology

Cite this

Randomized trial of laparoscopic donor nephrectomy with and without hand assistance. / Bargman, Vladislav; Sundaram, Chandru; Bernie, Jonathan; Goggins, William.

In: Journal of Endourology, Vol. 20, No. 10, 10.2006, p. 717-722.

Research output: Contribution to journalArticle

Bargman, Vladislav ; Sundaram, Chandru ; Bernie, Jonathan ; Goggins, William. / Randomized trial of laparoscopic donor nephrectomy with and without hand assistance. In: Journal of Endourology. 2006 ; Vol. 20, No. 10. pp. 717-722.
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title = "Randomized trial of laparoscopic donor nephrectomy with and without hand assistance",
abstract = "Purpose: To compare the early results of standard laparoscopic (SL) and hand-assisted laparoscopic (HAL) donor nephrectomy in a randomized study. Patients and Methods: Forty donors were randomly assigned in equal numbers to either SL or HAL. Two donors in the SL group and three patients in the HAL group underwent right nephrectomy; the others underwent left nephrectomy. In the SL group, specimen extraction was performed via a Pfannenstiel incision and in HAL group through a periumbilical midline incision. Objective intraoperative, hospital stay, and postoperative data as well as pain analog scores were collected prospectively. Patients completed the quality-of-life (QoL) SF-36 questionnaire preoperatively and at 1 month and 3 months of follow-up. Results: There was a statistically significant difference in the mean operative time in the two groups (200 ± 20.8 minutes for SL v 219 ± 28.3 minutes for HAL; P = 0.02). There was no difference in the mean estimated blood loss (141.5 ± 221.8 mL v 97.4 ± 73 mL, respectively; P = 0.41), warm ischemia time (157.5 ± 76.3 seconds v 135.5 ± 53.7 seconds; P = 0.32), length of postoperative hospital stay (1.9 ± 0.5 days v 2.1 ± 0.5 days; P = 0.61), intravenous analgesia (22.1 ± 14.0 mg v 28.3 ± 14.8 mg of morphine sulfate equivalent; P = 0.18), or pain score on postoperative day 1 (6.1 ± 1.0 v 6.2 ± 1.1) and 2 (3.3 ± 1.2 and 3.4 ± 1.3). There were five minor complications in the SL group and three in the HAL group. The mean preoperative (89.7 ± 4.8 v 89.2 ± 7.4; P = 0.84), 1-month (63.4 ± 13.9 v 64,5 ± 12.6; P = 0.82), and 3-month (82.7 ± 7.4 v 80.2 ± 8.4; P = 0.41) postoperative QoL scores did not differ significantly between the groups. None of the recipients required postoperative dialysis, and there was no statistical difference between the two groups in the serum creatinine concentration. Conclusion: Laparoscopic and hand-assisted donor nephrectomies have similar outcomes and postoperative pain. Both approaches are well tolerated with minimal complication rates and have similar impact on patients' quality of life.",
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AU - Bargman, Vladislav

AU - Sundaram, Chandru

AU - Bernie, Jonathan

AU - Goggins, William

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N2 - Purpose: To compare the early results of standard laparoscopic (SL) and hand-assisted laparoscopic (HAL) donor nephrectomy in a randomized study. Patients and Methods: Forty donors were randomly assigned in equal numbers to either SL or HAL. Two donors in the SL group and three patients in the HAL group underwent right nephrectomy; the others underwent left nephrectomy. In the SL group, specimen extraction was performed via a Pfannenstiel incision and in HAL group through a periumbilical midline incision. Objective intraoperative, hospital stay, and postoperative data as well as pain analog scores were collected prospectively. Patients completed the quality-of-life (QoL) SF-36 questionnaire preoperatively and at 1 month and 3 months of follow-up. Results: There was a statistically significant difference in the mean operative time in the two groups (200 ± 20.8 minutes for SL v 219 ± 28.3 minutes for HAL; P = 0.02). There was no difference in the mean estimated blood loss (141.5 ± 221.8 mL v 97.4 ± 73 mL, respectively; P = 0.41), warm ischemia time (157.5 ± 76.3 seconds v 135.5 ± 53.7 seconds; P = 0.32), length of postoperative hospital stay (1.9 ± 0.5 days v 2.1 ± 0.5 days; P = 0.61), intravenous analgesia (22.1 ± 14.0 mg v 28.3 ± 14.8 mg of morphine sulfate equivalent; P = 0.18), or pain score on postoperative day 1 (6.1 ± 1.0 v 6.2 ± 1.1) and 2 (3.3 ± 1.2 and 3.4 ± 1.3). There were five minor complications in the SL group and three in the HAL group. The mean preoperative (89.7 ± 4.8 v 89.2 ± 7.4; P = 0.84), 1-month (63.4 ± 13.9 v 64,5 ± 12.6; P = 0.82), and 3-month (82.7 ± 7.4 v 80.2 ± 8.4; P = 0.41) postoperative QoL scores did not differ significantly between the groups. None of the recipients required postoperative dialysis, and there was no statistical difference between the two groups in the serum creatinine concentration. Conclusion: Laparoscopic and hand-assisted donor nephrectomies have similar outcomes and postoperative pain. Both approaches are well tolerated with minimal complication rates and have similar impact on patients' quality of life.

AB - Purpose: To compare the early results of standard laparoscopic (SL) and hand-assisted laparoscopic (HAL) donor nephrectomy in a randomized study. Patients and Methods: Forty donors were randomly assigned in equal numbers to either SL or HAL. Two donors in the SL group and three patients in the HAL group underwent right nephrectomy; the others underwent left nephrectomy. In the SL group, specimen extraction was performed via a Pfannenstiel incision and in HAL group through a periumbilical midline incision. Objective intraoperative, hospital stay, and postoperative data as well as pain analog scores were collected prospectively. Patients completed the quality-of-life (QoL) SF-36 questionnaire preoperatively and at 1 month and 3 months of follow-up. Results: There was a statistically significant difference in the mean operative time in the two groups (200 ± 20.8 minutes for SL v 219 ± 28.3 minutes for HAL; P = 0.02). There was no difference in the mean estimated blood loss (141.5 ± 221.8 mL v 97.4 ± 73 mL, respectively; P = 0.41), warm ischemia time (157.5 ± 76.3 seconds v 135.5 ± 53.7 seconds; P = 0.32), length of postoperative hospital stay (1.9 ± 0.5 days v 2.1 ± 0.5 days; P = 0.61), intravenous analgesia (22.1 ± 14.0 mg v 28.3 ± 14.8 mg of morphine sulfate equivalent; P = 0.18), or pain score on postoperative day 1 (6.1 ± 1.0 v 6.2 ± 1.1) and 2 (3.3 ± 1.2 and 3.4 ± 1.3). There were five minor complications in the SL group and three in the HAL group. The mean preoperative (89.7 ± 4.8 v 89.2 ± 7.4; P = 0.84), 1-month (63.4 ± 13.9 v 64,5 ± 12.6; P = 0.82), and 3-month (82.7 ± 7.4 v 80.2 ± 8.4; P = 0.41) postoperative QoL scores did not differ significantly between the groups. None of the recipients required postoperative dialysis, and there was no statistical difference between the two groups in the serum creatinine concentration. Conclusion: Laparoscopic and hand-assisted donor nephrectomies have similar outcomes and postoperative pain. Both approaches are well tolerated with minimal complication rates and have similar impact on patients' quality of life.

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