Advertisement

Surgical Endoscopy

, Volume 27, Issue 8, pp 2801–2806 | Cite as

Incision-related outcome after live donor nephrectomy: a single-center experience

  • Karel W. J. Klop
  • Farah Hussain
  • Oguzhan Karatepe
  • Niels F. M. Kok
  • Jan N. M. IJzermans
  • Frank J. M. F. Dor
Article

Abstract

Background

Live donor nephrectomy is routinely performed. However, little is known regarding the incision-related outcome. The aim of the present study was to evaluate the prevalence of incisional hernias (IH) and to assess body image and cosmesis scores after donation.

Methods

Questionnaires on IH, body image, and cosmesis were sent to all donors who underwent laparoscopic donor nephrectomy or mini-incision donor nephrectomy between January 2000 and December 2009.

Results

In total, 444 replies were received (75 %). Seven donors (1.5 %) had undergone a surgical correction of an IH. Surgical site infection and steroid use appeared to be independent risk factors for the development of an IH (p = 0.001 and 0.021, respectively). Body image and cosmesis scores were excellent. Elderly donors had significantly higher cosmesis scores when compared with young donors (p < 0.001). Donor age of 60 years or higher, correction of an IH, and survival of the recipient appeared to be independent factors associated with a higher score on the cosmesis scale in multivariate analysis.

Conclusions

This is the largest study describing the prevalence of IH and cosmetic outcome after donor nephrectomy. The prevalence of IH after live donor nephrectomy is very low, and body image and cosmesis scores are excellent. Consequently, incision-related outcomes pose no barrier to live donor nephrectomy.

Keywords

Body image Cosmesis Incisional hernia Laparoscopic donor nephrectomy Mini-incision donor nephrectomy 

Notes

Disclosures

Karel W. J. Klop, Farah Hussain, Oguzhan Karatepe, Niels F. M. Kok, Jan N. M. IJzermans, and Frank J. M. F. Dor have no conflicts of interest or financial ties to disclose.

References

  1. 1.
    Mahillo B, Carmona M, Alvarez M, White S, Noel L, Matesanz R (2011) 2009 global data in organ donation and transplantation: activities, laws, and organization. Transplantation 92:1069–1074PubMedCrossRefGoogle Scholar
  2. 2.
    Klop KW, Dols LF, Kok NF, Weimar W, IJzermans JN (2012) Attitudes among surgeons towards live-donor nephrectomy: a European update. Transplantation 94(3):263–268PubMedCrossRefGoogle Scholar
  3. 3.
    Kok NF, Weimar W, Alwayn IP, IJzermans JN (2006) The current practice of live donor nephrectomy in Europe. Transplantation 82:892–897PubMedCrossRefGoogle Scholar
  4. 4.
    Dols LF, IJzermans JN, Wentink N, Tran TC, Zuidema WC, Dooper IM, Weimar W, Kok NF (2010) Long-term follow-up of a randomized trial comparing laparoscopic and mini-incision open live donor nephrectomy. Am J Transplant 10:2481–2487PubMedCrossRefGoogle Scholar
  5. 5.
    Kok NF, Lind MY, Hansson BM, Pilzecker D, Mertens zur Borg IR, Knipscheer BC, Hazebroek EJ, Dooper IM, Weimar W, Hop WC, Adang EM, Van der Wilt GJ, Bonjer HJ, van der Vliet JA, IJzermans JN (2006) Comparison of laparoscopic and mini incision open donor nephrectomy: single blind, randomised controlled clinical trial. BMJ 333:221PubMedCrossRefGoogle Scholar
  6. 6.
    Nicholson ML, Kaushik M, Lewis GR, Brook NR, Bagul A, Kay MD, Harper SJ, Elwell R, Veitch PS (2010) Randomized clinical trial of laparoscopic versus open donor nephrectomy. Br J Surg 97:21–28PubMedCrossRefGoogle Scholar
  7. 7.
    Oyen O, Andersen M, Mathisen L, Kvarstein G, Edwin B, Line PD, Scholz T, Pfeffer PF (2005) Laparoscopic versus open living-donor nephrectomy: experiences from a prospective, randomized, single-center study focusing on donor safety. Transplantation 79:1236–1240PubMedCrossRefGoogle Scholar
  8. 8.
    Clemens K, Boudville N, Dew MA, Geddes C, Gill JS, Jassal V, Klarenbach S, Knoll G, Muirhead N, Prasad GV, Storsley L, Treleaven D, Garg AX, Donor Nephrectomy Outcomes Research (DONOR) Network (2011) The long-term quality of life of living kidney donors: a multicenter cohort study. Am J Transplant 11:463–469PubMedCrossRefGoogle Scholar
  9. 9.
    Finan KR, Kilgore ML, Hawn MT (2009) Open suture versus mesh repair of primary incisional hernias: a cost-utility analysis. Hernia 13:173–182PubMedCrossRefGoogle Scholar
  10. 10.
    Snyder CW, Graham LA, Vick CC, Gray SH, Finan KR, Hawn MT (2011) Patient satisfaction, chronic pain, and quality of life after elective incisional hernia repair: effects of recurrence and repair technique. Hernia 15:123–129PubMedCrossRefGoogle Scholar
  11. 11.
    Aboutaleb E, Herbert P, Crane J, Hakim N (2010) Mini-incision donor nephrectomy techniques: a systematic review. Exp Clin Transplant 8:189–195PubMedGoogle Scholar
  12. 12.
    Diblasio CJ, Snyder ME, Russo P (2006) Mini-flank supra-11th rib incision for open partial or radical nephrectomy. BJU Int 97:149–156PubMedCrossRefGoogle Scholar
  13. 13.
    DeSouza A, Domajnko B, Park J, Marecik S, Prasad L, Abcarian H (2011) Incisional hernia, midline versus low transverse incision: What is the ideal incision for specimen extraction and hand-assisted laparoscopy? Surg Endosc 25:1031–1036PubMedCrossRefGoogle Scholar
  14. 14.
    Luijendijk RW, Jeekel J, Storm RK, Schutte PJ, Hop WC, Drogendijk AC, Huikeshoven FJ (1997) The low transverse Pfannenstiel incision and the prevalence of incisional hernia and nerve entrapment. Ann Surg 225:365–369PubMedCrossRefGoogle Scholar
  15. 15.
    Hussain A, Mahmood H, Singhal T, Balakrishnan S, Nicholls J, El-Hasani S (2009) Long-term study of port-site incisional hernia after laparoscopic procedures. JSLS 13:346–349PubMedGoogle Scholar
  16. 16.
    Di Lorenzo N, Coscarella G, Lirosi F, Pietrantuono M, Susanna F, Gaspari A (2005) Trocars and hernias: a simple, cheap remedy. Chir Ital 57:87–90PubMedGoogle Scholar
  17. 17.
    Di Lorenzo N, Coscarella G, Lirosi F, Gaspari A (2002) Port-site closure: a new problem, an old device. JSLS 6:181–183PubMedGoogle Scholar
  18. 18.
    Dunker MS, Bemelman WA, Slors JF, van Duijvendijk P, Gouma DJ (2001) Functional outcome, quality of life, body image, and cosmesis in patients after laparoscopic-assisted and conventional restorative proctocolectomy: a comparative study. Dis Colon Rectum 44:1800–1807PubMedCrossRefGoogle Scholar
  19. 19.
    Dunker MS, Stiggelbout AM, van Hogezand RA, Ringers J, Griffioen G, Bemelman WA (1998) Cosmesis and body image after laparoscopic-assisted and open ileocolic resection for Crohn’s disease. Surg Endosc 12:1334–1340PubMedCrossRefGoogle Scholar
  20. 20.
    Lind MY, Hop WC, Weimar W, IJzermans JN (2004) Body image after laparoscopic or open donor nephrectomy. Surg Endosc 18:1276–1279PubMedCrossRefGoogle Scholar
  21. 21.
    Hoer J, Lawong G, Klinge U, Schumpelick V (2002) Factors influencing the development of incisional hernia. A retrospective study of 2, 983 laparotomy patients over a period of 10 years. Chirug 73(5):474–480CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Karel W. J. Klop
    • 1
  • Farah Hussain
    • 1
  • Oguzhan Karatepe
    • 1
  • Niels F. M. Kok
    • 1
  • Jan N. M. IJzermans
    • 1
  • Frank J. M. F. Dor
    • 1
  1. 1.Division of Transplant Surgery, Department of SurgeryErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands

Personalised recommendations