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Papers of the Week

2019 Nov

J Laparoendosc Adv Surg Tech A



Morbidity Following Hand-Assisted Laparoscopic Donor Nephrectomy.


Ulyett S, Paraskeva P, Stacey S, Stell D, Akoh J, Barwell J, Aroori S
J Laparoendosc Adv Surg Tech A. 2019 Nov; 29(11):1427-1430.
PMID: 31621492.


The incidence of morbidity and readmission rate after hand-assisted laparoscopic donor nephrectomy (HALDN) is not clear. Our study aims to review our experience with HALDN, mainly the reasons for patient readmissions. Prospectively collected data on all patients undergoing HALDNs between August 2007 and June 2015 were retrieved. The primary outcome was 30-day readmission rate. Secondary outcomes were complications and readmission etiology. There were 161 nephrectomies with a median age of 51 years, 72 (44.7%) men, and 114 (70.8%) left-sided operations. Twenty-one (13%) individuals were readmitted within 30 days. There were total 25 (15.5%) readmissions during the study period. The characteristics of patients readmitted and patients not readmitted were broadly similar. Nine of 21 (43%) individuals readmitted had nonspecific findings (nonspecific findings on imaging, negative blood cultures, and raised inflammatory markers). The reasons for readmission were unrelated to nephrectomy in 24% and 19% required surgery for complications unrelated to nephrectomy. We observed a high readmission rate after HALDN. A significant proportion of readmissions were due to nonspecific abdominal pain associated with raised inflammatory markers and no obvious source of sepsis. Living donors should be fully informed about the risks including the possibility of complications unrelated to HALDN.