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Comparison of the iliac, vaginal and umbilical graft extraction in robot-assisted laparoscopic living donor nephrectomy

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Abstract

Purpose

To compare different extractions routes for robot-assisted living donor nephrectomy in terms of post-operative pain and renal function recovery.

Methods

Live donor kidney transplantation data from our institution were reviewed from November 2011 to March 2017. Postoperative pain was estimated using cumulative painkillers consumption. Variables were compared between the 3 groups with ANOVA for continuous data, χ2 test for categorial data. A survival analysis with Kaplan–Meier curve assessing time to transplant recipient nadir was performed to compare the renal function recovery.

Results

Sixty-three RLDN were performed (23 iliac, 23 vaginal and 17 umbilical extractions). There was no significant difference between the three groups in terms of operative time, blood lost, warm ischemia time, cumulative painkiller consumption and renal function recovery time. Postoperative complications for Umbilical, Vaginal and Iliac were, respectively, of 0, 3 and 1. No major difference was found between the 3 groups beside a slightly longer hospital stay in the iliac group.

Conclusion

Iliac incision might impact post-operative pain with a moderate but significant longer hospital stay. Vaginal extraction is an option when cosmetic outcomes present a real demand. The three options appeared to be safe and should be discussed with the patient in regard of the surgeon experience.

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Authors and Affiliations

  1. Department of Urology, APHP, Henri Mondor University Hospital, UPEC, 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France

    Maher Abdessater, Cécile M. Champy, José Batista da Costa, Jean Courcier, René Yiou, Andras Hoznek, Dimitri Vordos, Alexandre De la Taille & Alexandre Ingels

  2. Department of Nephrology, APHP, Henri Mondor University Hospital, UPEC, Créteil, France

    Philippe Grimbert, Marie Matignon & Tiphanie Londero

  3. Department of Clinical Investigations, APHP, Henri Mondor University Hospital, UPEC, Créteil, France

    Philippe le Corvoisier

  4. INSERM, CIC 1430, Créteil, France

    Philippe le Corvoisier

  5. Department of Urology, Hôpital Mont-de-Marsan, Mont-de-Marsan, France

    Laurent Salomon

Authors
  1. Maher Abdessater
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  2. Cécile M. Champy
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  3. José Batista da Costa
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  4. Jean Courcier
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  6. Andras Hoznek
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  7. Dimitri Vordos
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  8. Philippe Grimbert
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  9. Marie Matignon
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  11. Philippe le Corvoisier
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  12. Laurent Salomon
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  13. Alexandre De la Taille
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  14. Alexandre Ingels
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Contributions

MA project development, data collection, manuscript writing. CC data collection. JBATDC data collection and management, data analysis, data analysis. JC data collection. RY data collection. AH data collection. DV data collection. PG data collection. MM data collection. TL data collection. PLC data collection. LS project development. AdlT project development. AI project development, manuscript writing and editing.

Corresponding author

Correspondence to Alexandre Ingels.

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Authors declare no conflict of interest, source of funding: none.

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Research not involving Human Participants and/or Animals.

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Informed consent from patients was waived by institutional review board, since the data were collected from routine clinical activities.

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Abdessater, M., Champy, C.M., da Costa, J.B. et al. Comparison of the iliac, vaginal and umbilical graft extraction in robot-assisted laparoscopic living donor nephrectomy. World J Urol 39, 2783–2788 (2021). https://doi.org/10.1007/s00345-020-03462-y

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  • DOI: https://doi.org/10.1007/s00345-020-03462-y

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