Objectives: Reduction of burdens to live kidney donors are important. The aim of this study was to compare the surgical outcomes of 3 approaches we have been using for live-kidney donors: Transvaginal (TV), transumbilical single site (TUSS) and retroperitoneal with Pfannenstiel extraction (RPE).

Methods: 64 cases of live donor nephrectomy by a single surgeon were included in the study. The followings were compared among TV (n=13), TUSS (n=35) and RPE (n=16): operation time, blood loss, scar length sum, recipient serum creatinine at discharge (sCr), number of pain killer pills, visual analogue scale of postoperative pain (VAS) at day 1, 2, 3, 6 and the day of full meal recovery, the length of post-operative hospital stay and the frequency of complication (Clavien-Dindo classification >1).

Results: Operation time was longer in RPE than TV or TUSS (266, 226, 216 min). WIT was longer in RPE (5.6, 4.0, 3.5 min). The number of pain killer pills was less in TV than RPE or TUSS (2,4, 4.4, 4.5 pills). The day of full meal recovery was earlier in TV (1.6, 2.1, 2.4 days). The length of hospital stay was shorter in TV (6.1, 8.6, 8.3 days). Scar length sum was the shortest in TV (2.0, 10.2, 3.7cm). There were no difference among the approaches in blood loss, sCr and the frequency of complications. VAS (1.0, 1.4, 0.2, 0 vs 4.1, 2.8, 2.0, 0.5) were less in TV than TUSS.

Conclusions: Transvaginal approach provided not only faster recovery but better postoperative pain and appearance compared to TUSS or RPE without compromising surgical outcomes.

CITATION INFORMATION: Miura M., Higashiyama H. Comparison of Three Approaches for Laparoscopic Donor Nephrectomy: Transvaginal, Transumbilical Single Site and Retroperitoneal Am J Transplant. 2017;17 (suppl 3).

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