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Year : 2022  |  Volume : 33  |  Issue : 3  |  Page : 145-151

Safety and efficacy of laparoendoscopic single-site donor nephrectomy: A comparison of the transperitoneal and retroperitoneal approaches

1 Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
2 Department of Urology, Kaohsiung Medical University Hospital; Department of Urology, School of Medicine, College of Medicine; Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

Correspondence Address:
Chung-Yu Lin
No. 100, Tzyou 1st Road, Kaohsiung 807
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/UROS.UROS_146_21

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Purpose: Laparoscopic living-donor nephrectomy is the main technique at high-volume renal transplant centers. Laparoendoscopic single-site donor nephrectomy (LESS-DN) is s an evolutionary minimally invasive surgery, which could be performed by transperitoneal or retroperitoneal approaches. We present a retrospective analysis of our single-institution donor nephrectomy series comparing the transperitoneal to retroperitoneal LESS-DN regarding operative outcomes. Materials and Methods: Seventeen patients who underwent LESS-DN from 2017–2020 were enrolled at our center. The same surgeon performed all cases. The two approaches were compared for the operation time, blood loss, warm ischemia time (WIT), postoperative pain, length of stay (LOS), postoperative wound size, postoperative pain, and the postoperative renal function for twelve months retrospectively. Results: Operating time (257 vs. 180 min, P = 0.016) and LOS (6.5 vs. 5 days, P = 0.013) were significantly longer in the transperitoneal group. The postoperative wound size (47.5 vs. 75 mm, P = 0.038) was substantially smaller in the transperitoneal group. There was no significant difference in other parameters, including blood loss, WIT, complication rate, and postoperative pain from day one to day three. Conclusion: Retroperitoneal LESS-DN results in similar perioperative outcomes as transperitoneal LESS-DN without compromising donor safety and providing a faster operation time, shorter LOS, and a trend toward a shorter WIT. Both approach methods may be safe and effective procedures for living kidney transplantation.

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