Comparison of the Clinical Outcome and Surgical Invasiveness for Living Donor Nephrectomy Between Conventional Laparoscopic Surgery and Single-Port Surgery
Urology, Akita University Graduate School of Medicine, Akita, Japan.
Meeting: 2015 American Transplant Congress
Abstract number: B198
Keywords: Kidney, Kidney transplantation, Laparoscopy, Surgical complications
Session Information
Date: Sunday, May 3, 2015
Session Name: Poster Session B: Living Donor Issues 1
Session Time: 5:30pm-6:30pm
Presentation Time: 5:30pm-6:30pm
Location: Exhibit Hall E
INTRODUCTION AND OBJECTIVES:
Single-port surgery (SPS) for living donor nephrectomy (LDN) is challenging. Whether SPS is less invasive compared to conventional laparoscopic surgery (CLS) using several ports is unclear. LDN is an optimal model for evaluating surgical invasiveness by measuring circulating inflammatory cytokine levels because renal transplant donors are not affected by disease status. In this study, we compared the clinical outcome and surgical invasiveness for LDN between CLS and SPS.
METHODS:
We enrolled 137 donors (the CLS group: 64, the SPS group: 73) who underwent LDN in our hospital. In this study, the SPS group includes SPS plus one additional port (5 mm, n=32). Evaluation of both surgical techniques included comparison of conventional clinical parameters and preoperative, immediate postoperative, and 1-day postoperative levels of the following circulating inflammatory cytokines: Tumor necrosis factor (TNF)-alpha, interleukin (IL)-1b, IL-6, IL-8, IL-10, and IL-12p70.
RESULTS:
The frequency of right nephrectomy being performed was significantly lower in the SPS group than in the CLS group (6/64 vs 1/73, p = 0.03). Other clinical parameters in the SPS group, including the frequency of surgical complications and incidence of delayed graft function, were comparable to those in the CLS group. Immediate and 1-day postoperative mean serum IL-10 levels were significantly higher in the CLS group than in the SPS group (day 0; 12.2 ± 22.1 vs. 2.3 ± 1.4, p < 0.001, day 1; 5.3 ± 3.7 vs. 2.6 ± 0.9 pg/dL, p < 0.001, respectively). The 1-day postoperative mean serum TNF-alpha (9.5 ± 15.3 vs. 2.6 ± 2.4 pg/dL, p = 0.02) and IL-8 (54.6 ± 59.3 vs. 33.3 ± 13.4 pg/dL, p = 0.01) levels were also significantly higher in the CLS group than in the SPS group. Meanwhile, the mean serum IL-10, TNF-alpha, and IL-8 levels were not associated with surgical duration or estimated intraoperative blood loss.
CONCLUSIONS:
Conventional clinical parameters related to surgical invasiveness were not significantly different between both surgical techniques. While the results indicate that both techniques for LDN were similar and equally effective as minimally invasive surgeries, the inflammatory cytokine response suggested that SPS was less invasive than CLS.
To cite this abstract in AMA style:
Saito M, Satoh S, Yamamoto R, Tsuruta H, Akihama S, Inoue T, Narita S, Tsuchiya N, Habuchi T. Comparison of the Clinical Outcome and Surgical Invasiveness for Living Donor Nephrectomy Between Conventional Laparoscopic Surgery and Single-Port Surgery [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/comparison-of-the-clinical-outcome-and-surgical-invasiveness-for-living-donor-nephrectomy-between-conventional-laparoscopic-surgery-and-single-port-surgery/. Accessed December 1, 2020.« Back to 2015 American Transplant Congress