Objectives: To assess the safety and efficacy of introducing robotic-assisted laparoscopic donor nephrectomy (RALDN) to the standard retroperitoneal endoscopic donor nephrectomy (REDN). Methods: Data were collected prospectively from 124 consecutive living kidney donors (93 for REDN subgroup and 31 for RALDN subgroup) from February 2018 to December 2020. Donor baseline demographics, perioperative outcomes and recipient outcomes were recorded, and these parameters were compared between the two subgroups before and after propensity-score matching. Results: Mean age was 51.1 AE 9.1 years; 42.7% were males; mean body mass index was 22.7 AE 2.4; and there were 109 (88%) left kidneys. The following data of REDN and RALDN was, respectively, recorded: operative time (213 AE 43 versus 216 AE 39 min, p = 0.721), warm ischemic time (4.7 AE 1.2 versus 4.9 AE 1.4 min, p = 0.399), postoperative complications (5.4% versus 6.5%, p = 1), haemoglobin (g/L) drop (9.4 AE 7.2 versus 9.7 AE 6.6, p = 0.836), blood creatinine at 6 month (1.15 AE 0.23 versus 1.13 AE 0.24 mg/dL, p = 0.734) and at 1 year (1.09 AE 0.22 versus 1.17 AE 0.28 mg/dL, p = 0.591). In postpropensity score matched analyses, there was no significant differences between the two groups including intraoperative and postoperative complications. Conclusions: RALDN could be safely introduced into a living donor program experienced in laparoscopic donor nephrectomy. The outcomes of our study comparing these minimally invasive techniques are mostly similar in terms of intraoperative and postoperative outcomes for kidney donors.Abbreviations: ASA American society of anesthesiologists; BMI body mass index; eGFR estimated glomerular filtration rate; HLA Human Leukocyte Antigens; RALDN Robotic-assisted laparoscopic donor nephrectomy; REDN Retroperitoneal endoscopic donor nephrectomy; SCr serum creatinine.Bold values are p-value less than 0.05 and are considered statistically significant.
Background: This study aims to assess safety and efficacy of introducing robot-assisted laparoscopic donor nephrectomy (RALDN) to the standard retroperitoneal endoscopic living donor nephrectomy (RELDN) at a single institution transplant program. Methods: Data were collected prospectively from 68 consecutive living kidney donors (14 for RALDN subgroup and 54 RELDN subgroup) at a transplant center from February 2018 to September 2019. Patient baseline demographics, radiological findings, perioperative donor outcomes, recipient outcomes, and complications were recorded, and these parameters were compared between the two surgical groups. Results: For the entire group, mean age±standard deviation was 51.4±8.9 years (range, 29-68 years); 44.1% were males; mean body mass index (BMI) was 22.6±2.3 kg/m 2 (range, 15.6-27.3 kg/m 2); and there were 57 (84%) left kidneys. Preoperatively, there was no significant differences (P>0.05) between the two donor groups including gender, BMI, kidney side, hilar anatomy, and American Society of Anesthesiologists status. For perioperative outcomes, there was no significant differences (P>0.05) comparing RALDN and RELDN respectively for warm ischemic time (4.7±1.4 minutes vs. 4.8±1.4 minutes), operative time (232±43 minutes vs. 217±41 minutes), hemoglobin drop (7.5±5.8 g/L vs. 8.5±7.2 g/L), postoperative complications (7.1% vs. 7.4%), the donor blood creatinine at 1 month (1.13±0.22 mg/dL vs. 1.22±0.26 mg/dL), and the recipient blood creatinine at 1 month (1.25±0.28 mg/dL vs. 1.41±0.38 mg/dL). Conclusions: This study showed that RALDN can be safely introduced into living donor program experienced in laparoscopic donor nephrectomy.
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