Comparison of open live donor nephrectomy, laparoscopic live donor nephrectomy, and hand-assisted live donor nephrectomy: a cost-minimization analysis.

摘要: Abstract Background Live donor kidney transplantation is the treatment of choice for end-stage renal disease. Open nephrectomy (ODN) was standard until introduction laparoscopic (LDN) in 1995. Hand-assisted (HALDN) added shortly thereafter. The techniques are associated with increased operating room times and equipment costs; however, these speed patient return to normal activity. aim this study evaluate cost techniques. Materials Methods A decision analysis model developed simulate outcomes donors undergoing ODN, LDN, HALDN. Outcomes were simulated from both institutional perspective (IP) societal (SP). Baseline values ranges determined a systematic review literature. Sensitivity analyses conducted test strength. Results From IP, ODN least costly strategy $11,000, while $15,200 HALDN $15,800 LDN. SP, costing $27,800, LDN $29,000 $41,000. In sensitivity analysis, only became dominant if days till work exceeded 58 strategy. nearly equivalent as rate open conversion approached zero. Conclusions strategy, especially SP. primary determinants work.