Anterior vertical mini-incision vs. retroperitoneoscopic nephrectomy in living kidney donation: a prospective study on donors' quality of life and clinical outcome
Autor: | Martina Koch, Karl-Heinz Schulz, Sylvia Kroencke, Björn Nashan |
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Rok vydání: | 2015 |
Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Nephrectomy Quality of life medicine Living Donors Humans Minimally Invasive Surgical Procedures Postoperative Period Prospective Studies Retroperitoneal Space Laparoscopy Prospective cohort study Kidney transplantation Transplantation medicine.diagnostic_test business.industry Kidney donation Physical health Length of Stay Middle Aged medicine.disease Prognosis Kidney Transplantation humanities Surgery Mini incision Quality of Life Tissue and Organ Harvesting Kidney Failure Chronic Female business Follow-Up Studies |
Zdroj: | Clinical transplantation. 29(11) |
ISSN: | 1399-0012 |
Popis: | Background A fundamental goal in living kidney donation (LKD) is to maximize donor safety while minimizing post-operative impairments. We evaluated clinical outcome and health-related quality of life (QOL) comparing anterior vertical mini-incision donor nephrectomy (MIDN) and retroperitoneoscopic donor nephrectomy (RPDN). Methods Thirty-eight MIDN and 45 RPDN donors were analyzed. In a subsample (n = 18 MIDN; n = 32 RPDN), QOL was prospectively assessed with the WHOQOL-Bref questionnaire before and three months after LKD. Results Skin-to-skin time (169 vs. 116 min, p < 0.001) and hospital stay (6.6 vs. 4.9 d, p < 0.001) were significantly shorter in RPDN. In total, 26% of MIDN patients and 13% of RPDN patients developed post-operative complications (p = 0.14). While in MIDN the QOL domains physical health (p = 0.03) and psychological (p = 0.03) and the overall QOL facet (p = 0.003) were significantly lower three months post-LKD compared to baseline, there were no significant QOL decreases in RPDN. However, no significant post-operative QOL differences were found between groups. RPDN donors retrospectively reported significantly less post-operative pain (p = 0.007) and physical strain (p = 0.05) caused by LKD than MIDN donors. Conclusions It may be possible to further reduce the surgical burden of LKD by introducing RPDN. Post-operative QOL was not significantly different between groups, but the QOL decrease appeared to be less pronounced in RPDN. |
Databáze: | OpenAIRE |
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