Minilaparoscopy vs. standard laparoscopic donor nephrectomy: comparison of safety, efficacy and cosmetic outcomes in a randomized clinical trial.

Urology Journal 2015; 12(4): 2223-2227.

Aims
To compare safety, efficacy and cosmetic outcomes between standard laparoscopic live donor nephrectomy (sLDN) and minilaparoscopic donor nephrectomy (mLDN).

Interventions
Patients were randomized to sLDN versus mLDN

Participants
100 consecutive kidney donors

Outcomes
Measured outcomes were total operative time, warm ichemic time, hospital stay, surgical blood loss, peri or post-operative complications, kidney graft function, graft loss and cosmetic appearance.

Follow-up
Mean 9 months (6-19 months)

CET Conclusions
This paper compared standard live donor nephrectomy with “mini” live donor nephrectomy. The two techniques seem to be very similar; they both require 4 ports, although for the mini technique some of these are smaller. The main outcome of the study was safety although this was not specifically defined in the paper and the outcome used for the power calculation is not mentioned, nor the expected event rates for any safety outcomes. The method of randomisation was not described. Importantly the study only included left kidney nephrectomies with only one renal artery. There were no conversions to open in either group, operating and ischaemic times were very similar. Donors reported that they had improved appearance of scars in the minilaparoscopy group, however this did not translate to improved satisfaction with scar appearance or symptoms.

Jadad score
2

Data analysis
Per protocol analysis

Allocation concealment
No

Trial registration
None

Funding source
Not reported