Category: Laparoscopic/ Robotic: Other
Introduction & Objective :
Laparoscopic transperitoneal nephrectomy was firstly performed at our hospital on 28 May 2004. Since August 2005, we completely performed retroperitoneal laparoscopic living donor nephrectomy (RLLDN) for kidney harvesting. To assess the safety, feasibility, and results of RPLDN, we analyzed the data of RLLDN to assess outcomes and evaluate our experience in the series of RLLDN operated on by a single team over a 10-year period at our hospital.
Data were collected prospectively on 400 donors with RLLDN at our hospital from August 2005 to May 2017. The donors were chosen by the Renal Transplantation Council of our Hospital (donor national criteria). All of them were related living donors, except who can demonstrate the humanitarian motive and non-remunerated donor. To choose the side of the kidney to harvest, we prefer to remain the best function kidney (by renal isotopic scan) or the healthy kidney of the donor. The abnormally of kidney vessels with multiple arteries were not the main criteria of side choosing. Patient demographics, radiology findings, surgery results, peri-operative complications, warm ischemia time, hospital stay and follow-up results were recorded. The primary outcomes were intraoperative surgical results. The secondary outcomes were postoperative kidney function and postoperative complication.
There were 400 cases of RLLDN (55.75% females and 44.25% males). The mean age of the series was 46.5 ± 8.9 years. The mean BMI was 22.2 ± 3.1 (17.1- 35.4). There were 124 right kidneys and 276 left kidneys. Donor nephrectomy was performed successfully in all patients, without conversion to open surgery. No intraoperative complication neither mortality was seen. The average of the warm ischemic time was 4.5 ± 1.4 minutes. Postoperative complications were two cases (0.5%) of post-transplant ureteral fistula and two cases (0.5%) of postoperative bleeding requiring surgical intervention. All of the grafts were functioned well in the first hour of transplantation. The remaining kidney functioned well with the average of serum creatinine were 1.3 ± 0.2 mg/dL to compare with 0.9 ± 0.5 mg/dL before the nephrectomy. The average hospitalized time was 4.8 ± 1.2 days.
At our hospital, 400 RLLDN cases were performed successfully over a 10-year period. The technique was relatively simple and feasible in Vietnam with standard instruments for laparoscopic surgery. Generally, the transplantation kidney function was normal during the post-transplant period.
Thanh-Tuan Nguyen– Doctor, University of Medicine and Pharmacy at Ho Chi Minh city, Cho Ray Hospital, Ho Chi Minh, Ho Chi Minh, Vietnam
Quy Thuan Chau– Ho Chi Minh, Ho Chi Minh, Vietnam
Do La Quach– Ho Chi Minh, Ho Chi Minh, Vietnam
Kinh Luan Thai– Ho Chi Minh, Ho Chi Minh, Vietnam
Duc Huy Vu– Ho Chi Minh, Ho Chi Minh, Vietnam
Duy Dien Nguyen– Ho Chi Minh, Ho Chi Minh, Vietnam
Trong Tri Tran– Ho Chi Minh, Ho Chi Minh, Vietnam
Khac Chuan Hoang– Ho Chi Minh, Ho Chi Minh, Vietnam
Xuan Thai Ngo– Ho Chi Minh, Ho Chi Minh, Vietnam
Minh Sam Thai– Ho Chi Minh, Ho Chi Minh, Vietnam
Ngoc Sinh Tran– Ho Chi Minh, Ho Chi Minh, Vietnam
University of Medicine and Pharmacy at Ho Chi Minh city, Cho Ray Hospital
Ho Chi Minh, Ho Chi Minh, Vietnam
Nguyen Thanh Tuan
Urologist - Cho Ray hospital
Lecturer - University of Medicine and Pharmacy at Ho Chi Minh City