Laparoscopic donor nephrectomy: intraoperative safety, immediate morbidity, and delayed complications with 500 cases.

摘要: Several large series of laparoscopic donor nephrectomy (LDN) have been published, largely focusing on immediate results and short-term complications. The aim this study was to examine the LDN collect medium-term long-term followup. We examined two surgeons who performed 500 consecutive LDNs from 1996 2005. Prospective databases were reviewed for both donors recipients record demographics, medical history, intraoperative events, Patients followed between 1 month 9 years after surgery assess delayed complications, especially hypertension, renal insufficiency, incisional hernia, bowel obstruction, chronic pain. Left kidneys procured in 86.2% cases. Mean operative time 3.5 h, warm ischemia averaged 3.4 min. Hand-assistance used 13.8%, conversion rate 1.8%. Intraoperative complication 5.8% predominantly bleeding (93.1%). Most (86.2%) complications occurred during initial 150 cases a surgeon, compared with 10.3% subsequent (p = 0.003). Operative decreased by 87 min < 0.001). Immediate graft survival 97.5%. Delayed function 3.0% recipients, acute tubular necrosis 7.0%. Thirty-day 9.8%. creatinine 1.24 first postoperative day, 1.27 at 2 weeks, year. At mean followup 32.8 months, consisted 11 prolonged pain or paresthesia, hernias, small obstruction requiring lysis adhesions, hydrocele repair. can be acceptable morbidity excellent function. significantly surgeon Long-term uncommon but included likely underestimated incidence hypertension.