Comparison of laparoscopic and mini incision open donor nephrectomy: single blind, randomised controlled clinical trial
Abstract Objectives To determine the best approach for live donor nephrectomy to minimise discomfort to the donor and to provide good graft function. Design Single blind, randomised controlled trial. Setting Two university medical centres, the Netherlands. Participants 100 living kidney donors. Inte...
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| Published in: | BMJ Vol. 333; no. 7561; pp. 221 - 224 |
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| Main Authors: | , , , , , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
London
British Medical Journal Publishing Group
29-07-2006
British Medical Association BMJ Publishing Group LTD BMJ Publishing Group BMJ Publishing Group Ltd |
| Edition: | International edition |
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| Online Access: | Get full text |
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| Abstract | Abstract Objectives To determine the best approach for live donor nephrectomy to minimise discomfort to the donor and to provide good graft function. Design Single blind, randomised controlled trial. Setting Two university medical centres, the Netherlands. Participants 100 living kidney donors. Interventions Participants were randomly assigned to either laparoscopic donor nephrectomy or to mini incision muscle splitting open donor nephrectomy. Main outcome measures The primary outcome was physical fatigue using the multidimensional fatigue inventory 20 (MFI-20). Secondary outcomes were physical function using the SF-36, hospital stay after surgery, pain, operating times, recipient graft function, and graft survival. Results Conversions did not occur. Compared with mini incision open donor nephrectomy, laparoscopic donor nephrectomy resulted in longer skin to skin time (median 221 v 164 minutes, P < 0.001), longer warm ischaemia time (6 v 3 minutes, P < 0.001), less blood loss (100 v 240 ml, P < 0.001), and a similar number of complications (intraoperatively 12% v 6%, P = 0.49, postoperatively both 6%). After laparoscopic nephrectomy, donors required less morphine (16 v 25 mg, P = 0.005) and shorter hospital stay (3 v 4 days, P = 0.003). During one year's follow-up mean physical fatigue was less (difference - 1.3, 95% confidence interval - 2.4 to - 0.1) and physical function was better (difference 6.2, 2.0 to 10.3) after laparoscopic nephrectomy. Function of the graft and graft survival rate of the recipient at one year censored for death did not differ (100% after laparoscopic nephrectomy and 98% after open nephrectomy). Conclusions Laparoscopic donor nephrectomy results in a better quality of life compared with mini incision open donor nephrectomy but equal safety and graft function. |
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| AbstractList | Objectives To determine the best approach for live donor nephrectomy to minimise discomfort to the donor and to provide good graft function. Design Single blind, randomised controlled trial. Setting Two university medical centres, the Netherlands. Participants 100 living kidney donors. Interventions Participants were randomly assigned to either laparoscopic donor nephrectomy or to mini incision muscle splitting open donor nephrectomy. Main outcome measures The primary outcome was physical fatigue using the multidimensional fatigue inventory 20 (MFI-20). Secondary outcomes were physical function using the SF-36, hospital stay after surgery, pain, operating times, recipient graft function, and graft survival. Results Compared with mini incision open donor nephrectomy, laparoscopic donor nephrectomy resulted in longer skin to skin time (median 221 v 164 minutes, P < 0.001), longer warm ischaemia time (6 v 3 minutes, P < 0.001 ), less blood loss (100 v 240 ml, P < 0.001), and a similar number of complications (intraoperatively 12% v 6%, P = 0.49, postoperatively both 6%). After laparoscopic nephrectomy, donors required less morphine (16 v 25 mg, P = 0.005) and shorter hospital stay (3 v 4 days, P = 0.003). During one year's follow-up mean physical fatigue was less (difference -1.3, 95% confidence interval -2.4 to -0.1) and physical function was better (difference 6.2, 2.0 to 10.3) after laparoscopic nephrectomy. Function of the graft and graft survival rate of the recipient at one year censored for death did not differ (100% after laparoscopic nephrectomy and 98% after open nephrectomy). Conclusions Laparoscopic donor nephrectomy results in a better quality of life compared with mini incision open donor nephrectomy but equal safety and graft function. Objectives To determine the best approach for live donor nephrectomy to minimise discomfort to the donor and to provide good graft function. Design Single blind, randomised controlled trial. Setting Two university medical centres, the Netherlands. Participants 100 living kidney donors. Interventions Participants were randomly assigned to either laparoscopic donor nephrectomy or to mini incision muscle splitting open donor nephrectomy. Main outcome measures The primary outcome was physical fatigue using the multidimensional fatigue inventory 20 (MFI-20). Secondary outcomes were physical function using the SF-36, hospital stay after surgery, pain, operating times, recipient graft function, and graft survival. Results Conversions did not occur. Compared with mini incision open donor nephrectomy, laparoscopic donor nephrectomy resulted in longer skin to skin time (median 221 v 164 minutes, P < 0.001), longer warm ischaemia time (6 v 3 minutes, P < 0.001), less blood loss (100 v 240 ml, P < 0.001), and a similar number of complications (intraoperatively 12% v 6%, P = 0.49, postoperatively both 6%). After laparoscopic nephrectomy, donors required less morphine (16 v 25 mg, P = 0.005) and shorter hospital stay (3 v 4 days, P = 0.003). During one year's follow-up mean physical fatigue was less (difference - 1.3, 95% confidence interval - 2.4 to - 0.1) and physical function was better (difference 6.2, 2.0 to 10.3) after laparoscopic nephrectomy. Function of the graft and graft survival rate of the recipient at one year censored for death did not differ (100% after laparoscopic nephrectomy and 98% after open nephrectomy). Conclusions Laparoscopic donor nephrectomy results in a better quality of life compared with mini incision open donor nephrectomy but equal safety and graft function. Abstract Objectives To determine the best approach for live donor nephrectomy to minimise discomfort to the donor and to provide good graft function. Design Single blind, randomised controlled trial. Setting Two university medical centres, the Netherlands. Participants 100 living kidney donors. Interventions Participants were randomly assigned to either laparoscopic donor nephrectomy or to mini incision muscle splitting open donor nephrectomy. Main outcome measures The primary outcome was physical fatigue using the multidimensional fatigue inventory 20 (MFI-20). Secondary outcomes were physical function using the SF-36, hospital stay after surgery, pain, operating times, recipient graft function, and graft survival. Results Conversions did not occur. Compared with mini incision open donor nephrectomy, laparoscopic donor nephrectomy resulted in longer skin to skin time (median 221 v 164 minutes, P < 0.001), longer warm ischaemia time (6 v 3 minutes, P < 0.001), less blood loss (100 v 240 ml, P < 0.001), and a similar number of complications (intraoperatively 12% v 6%, P = 0.49, postoperatively both 6%). After laparoscopic nephrectomy, donors required less morphine (16 v 25 mg, P = 0.005) and shorter hospital stay (3 v 4 days, P = 0.003). During one year's follow-up mean physical fatigue was less (difference - 1.3, 95% confidence interval - 2.4 to - 0.1) and physical function was better (difference 6.2, 2.0 to 10.3) after laparoscopic nephrectomy. Function of the graft and graft survival rate of the recipient at one year censored for death did not differ (100% after laparoscopic nephrectomy and 98% after open nephrectomy). Conclusions Laparoscopic donor nephrectomy results in a better quality of life compared with mini incision open donor nephrectomy but equal safety and graft function. OBJECTIVESTo determine the best approach for live donor nephrectomy to minimise discomfort to the donor and to provide good graft function.DESIGNSingle blind, randomised controlled trial.SETTINGTwo university medical centres, the Netherlands.PARTICIPANTS100 living kidney donors.INTERVENTIONSParticipants were randomly assigned to either laparoscopic donor nephrectomy or to mini incision muscle splitting open donor nephrectomy.MAIN OUTCOME MEASURESThe primary outcome was physical fatigue using the multidimensional fatigue inventory 20 (MFI-20). Secondary outcomes were physical function using the SF-36, hospital stay after surgery, pain, operating times, recipient graft function, and graft survival.RESULTSConversions did not occur. Compared with mini incision open donor nephrectomy, laparoscopic donor nephrectomy resulted in longer skin to skin time (median 221 v 164 minutes, P < 0.001), longer warm ischaemia time (6 v 3 minutes, P < 0.001), less blood loss (100 v 240 ml, P < 0.001), and a similar number of complications (intraoperatively 12% v 6%, P = 0.49, postoperatively both 6%). After laparoscopic nephrectomy, donors required less morphine (16 v 25 mg, P = 0.005) and shorter hospital stay (3 v 4 days, P = 0.003). During one year's follow-up mean physical fatigue was less (difference - 1.3, 95% confidence interval - 2.4 to - 0.1) and physical function was better (difference 6.2, 2.0 to 10.3) after laparoscopic nephrectomy. Function of the graft and graft survival rate of the recipient at one year censored for death did not differ (100% after laparoscopic nephrectomy and 98% after open nephrectomy).CONCLUSIONSLaparoscopic donor nephrectomy results in a better quality of life compared with mini incision open donor nephrectomy but equal safety and graft function. Objectives: To determine the best approach for live donor nephrectomy to minimise discomfort to the donor and to provide good graft function. Design: Single blind, randomised controlled trial. Setting: Two university medical centres, the Netherlands. Participants: 100 living kidney donors. Interventions: Participants were randomly assigned to either laparoscopic donor nephrectomy or to mini incision muscle splitting open donor nephrectomy. Main outcome measures: The primary outcome was physical fatigue using the multidimensional fatigue inventory 20 (MFI-20). Secondary outcomes were physical function using the SF-36, hospital stay after surgery, pain, operating times, recipient graft function, and graft survival. Results: Conversions did not occur. Compared with mini incision open donor nephrectomy, laparoscopic donor nephrectomy resulted in longer skin to skin time (median 221 v 164 minutes, P < 0.001), longer warm ischaemia time (6 v 3 minutes, P < 0.001), less blood loss (100 v 240 ml, P < 0.001), and a similar number of complications (intraoperatively 12% v 6%, P = 0.49, postoperatively both 6%). After laparoscopic nephrectomy, donors required less morphine (16 v 25 mg, P = 0.005) and shorter hospital stay (3 v 4 days, P = 0.003). During one year's follow-up mean physical fatigue was less (difference - 1.3, 95% confidence interval - 2.4 to - 0.1) and physical function was better (difference 6.2, 2.0 to 10.3) after laparoscopic nephrectomy. Function of the graft and graft survival rate of the recipient at one year censored for death did not differ (100% after laparoscopic nephrectomy and 98% after open nephrectomy). Conclusions: Laparoscopic donor nephrectomy results in a better quality of life compared with mini incision open donor nephrectomy but equal safety and graft function. [PUBLICATION ABSTRACT] To determine the best approach for live donor nephrectomy to minimise discomfort to the donor and to provide good graft function. Single blind, randomised controlled trial. Two university medical centres, the Netherlands. 100 living kidney donors. Participants were randomly assigned to either laparoscopic donor nephrectomy or to mini incision muscle splitting open donor nephrectomy. The primary outcome was physical fatigue using the multidimensional fatigue inventory 20 (MFI-20). Secondary outcomes were physical function using the SF-36, hospital stay after surgery, pain, operating times, recipient graft function, and graft survival. Conversions did not occur. Compared with mini incision open donor nephrectomy, laparoscopic donor nephrectomy resulted in longer skin to skin time (median 221 v 164 minutes, P < 0.001), longer warm ischaemia time (6 v 3 minutes, P < 0.001), less blood loss (100 v 240 ml, P < 0.001), and a similar number of complications (intraoperatively 12% v 6%, P = 0.49, postoperatively both 6%). After laparoscopic nephrectomy, donors required less morphine (16 v 25 mg, P = 0.005) and shorter hospital stay (3 v 4 days, P = 0.003). During one year's follow-up mean physical fatigue was less (difference - 1.3, 95% confidence interval - 2.4 to - 0.1) and physical function was better (difference 6.2, 2.0 to 10.3) after laparoscopic nephrectomy. Function of the graft and graft survival rate of the recipient at one year censored for death did not differ (100% after laparoscopic nephrectomy and 98% after open nephrectomy). Laparoscopic donor nephrectomy results in a better quality of life compared with mini incision open donor nephrectomy but equal safety and graft function. Objectives To determine the best approach for live donor nephrectomy to minimise discomfort to the donor and to provide good graft function. Design Single blind, randomised controlled trial. Setting Two university medical centres, the Netherlands. Participants 100 living kidney donors. Interventions Participants were randomly assigned to either laparoscopic donor nephrectomy or to mini incision muscle splitting open donor nephrectomy. Main outcome measures The primary outcome was physical fatigue using the multidimensional fatigue inventory 20 (MFI-20). Secondary outcomes were physical function using the SF-36, hospital stay after surgery, pain, operating times, recipient graft function, and graft survival. Results Conversions did not occur. Compared with mini incision open donor nephrectomy, laparoscopic donor nephrectomy resulted in longer skin to skin time (median 221 v 164 minutes, P < 0.001), longer warm ischaemia time (6 v 3 minutes, P < 0.001), less blood loss (100 v 240 ml, P < 0.001), and a similar number of complications (intraoperatively 12% v 6%, P = 0.49, postoperatively both 6%). After laparoscopic nephrectomy, donors required less morphine (16 v 25 mg, P = 0.005) and shorter hospital stay (3 v 4 days, P = 0.003). During one year's follow-up mean physical fatigue was less (difference - 1.3, 95% confidence interval - 2.4 to - 0.1) and physical function was better (difference 6.2, 2.0 to 10.3) after laparoscopic nephrectomy. Function of the graft and graft survival rate of the recipient at one year censored for death did not differ (100% after laparoscopic nephrectomy and 98% after open nephrectomy). Conclusions Laparoscopic donor nephrectomy results in a better quality of life compared with mini incision open donor nephrectomy but equal safety and graft function. |
| Author | van der Wilt, Gert Jan Hansson, Birgitta M E Kok, Niels F M Hazebroek, Eric J Dooper, Ine M Mertens zur Borg, Ingrid R A M Lind, May Y Hop, Wim C J Bonjer, Hendrik J Pilzecker, Desiree Weimar, Willem van der Vliet, Jordanus A Knipscheer, Ben C Adang, Eddy M M IJzermans, Jan N M |
| AuthorAffiliation | 3 Department of Nephrology, Radboud University Medical Centre 7 Department of Epidemiology and Biostatistics, Erasmus MC 6 Department of Nephrology, Erasmus MC 1 Department of Surgery, Erasmus MC, PO Box 2040, 3000 CA Rotterdam, Netherlands 2 Department of Surgery, Radboud University Medical Centre, Nijmegen, Netherlands 4 Department of Anaesthesiology, Erasmus MC 5 Department of Urology, Radboud University Medical Centre 8 Department of Medical Technology Assessment, Radboud University Medical Centre |
| AuthorAffiliation_xml | – name: 5 Department of Urology, Radboud University Medical Centre – name: 6 Department of Nephrology, Erasmus MC – name: 3 Department of Nephrology, Radboud University Medical Centre – name: 4 Department of Anaesthesiology, Erasmus MC – name: 2 Department of Surgery, Radboud University Medical Centre, Nijmegen, Netherlands – name: 8 Department of Medical Technology Assessment, Radboud University Medical Centre – name: 7 Department of Epidemiology and Biostatistics, Erasmus MC – name: 1 Department of Surgery, Erasmus MC, PO Box 2040, 3000 CA Rotterdam, Netherlands |
| Author_xml | – sequence: 1 givenname: Niels F M surname: Kok fullname: Kok, Niels F M organization: Department of Surgery, Erasmus MC, PO Box , CA Rotterdam, Netherlands – sequence: 2 givenname: May Y surname: Lind fullname: Lind, May Y organization: Department of Surgery, Erasmus MC, PO Box , CA Rotterdam, Netherlands – sequence: 3 givenname: Birgitta M E surname: Hansson fullname: Hansson, Birgitta M E organization: Department of Surgery, Radboud University Medical Centre, Nijmegen, Netherlands – sequence: 4 givenname: Desiree surname: Pilzecker fullname: Pilzecker, Desiree organization: Department of Nephrology, Radboud University Medical Centre – sequence: 5 givenname: Ingrid R A M surname: Mertens zur Borg fullname: Mertens zur Borg, Ingrid R A M organization: Department of Anaesthesiology, Erasmus MC – sequence: 6 givenname: Ben C surname: Knipscheer fullname: Knipscheer, Ben C organization: Department of Urology, Radboud University Medical Centre – sequence: 7 givenname: Eric J surname: Hazebroek fullname: Hazebroek, Eric J organization: Department of Surgery, Erasmus MC, PO Box , CA Rotterdam, Netherlands – sequence: 8 givenname: Ine M surname: Dooper fullname: Dooper, Ine M organization: Department of Nephrology, Radboud University Medical Centre – sequence: 9 givenname: Willem surname: Weimar fullname: Weimar, Willem organization: Department of Nephrology, Erasmus MC – sequence: 10 givenname: Wim C J surname: Hop fullname: Hop, Wim C J organization: Department of Epidemiology and Biostatistics, Erasmus MC – sequence: 11 givenname: Eddy M M surname: Adang fullname: Adang, Eddy M M organization: Department of Medical Technology Assessment, Radboud University Medical Centre – sequence: 12 givenname: Gert Jan surname: van der Wilt fullname: van der Wilt, Gert Jan organization: Department of Medical Technology Assessment, Radboud University Medical Centre – sequence: 13 givenname: Hendrik J surname: Bonjer fullname: Bonjer, Hendrik J organization: Department of Surgery, Erasmus MC, PO Box , CA Rotterdam, Netherlands – sequence: 14 givenname: Jordanus A surname: van der Vliet fullname: van der Vliet, Jordanus A organization: Department of Surgery, Radboud University Medical Centre, Nijmegen, Netherlands – sequence: 15 givenname: Jan N M surname: IJzermans fullname: IJzermans, Jan N M email: j.ijzermans@erasmusmc.nl organization: Department of Surgery, Erasmus MC, PO Box , CA Rotterdam, Netherlands |
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| ContentType | Journal Article |
| Copyright | 2006 BMJ Publishing Group Ltd. 2006 BMJ Publishing Group Ltd 2006 INIST-CNRS Copyright: 2006 (c) 2006 BMJ Publishing Group Ltd. Copyright BMJ Publishing Group Jul 29, 2006 Copyright © 2006, BMJ Publishing Group Ltd. 2006 |
| Copyright_xml | – notice: 2006 BMJ Publishing Group Ltd. – notice: 2006 BMJ Publishing Group Ltd – notice: 2006 INIST-CNRS – notice: Copyright: 2006 (c) 2006 BMJ Publishing Group Ltd. – notice: Copyright BMJ Publishing Group Jul 29, 2006 – notice: Copyright © 2006, BMJ Publishing Group Ltd. 2006 |
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| DOI | 10.1136/bmj.38886.618947.7C |
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| Keywords | Human Incision Medicine Treatment Donor Nephrectomy Surgery Randomised controlled trial Clinical trial Laparoscopy Endoscopy Comparative study |
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| Notes | local:bmj;333/7561/221 istex:E968BCC61CECDA0491EE53D6F8044C995A82887C ArticleID:bmj.38886.618947.7C href:bmj-333-221.pdf PMID:16847014 Correspondence to: J N M IJzermans ark:/67375/NVC-TC3GXDMX-R ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-News-2 ObjectType-Feature-3 content type line 23 Funding: This study was supported by unrestricted grants from the Society of American Gastrointestinal Endoscopic Surgeons and the Dutch Kidney Foundation. Competing interest: None declared. Table with data for additional dimensions is on bmj.com Contributors: WW, BMEH, GJvdW, EJH, IRAMMzB, HJB, JAvdV, and JNMI contributed to the design and initial planning of this study. BMEH, BCK, HJB, and JNMIJ attended all operations and controlled the carrying out of the surgical technique. NFMK, MYL, EJH, and DP collected the donors' data. WW and IMD collected the recipients' data. WCJH was the trial statistician. NFMK, EMMA, and GJvdW were responsible for collecting, analysing, interpreting, and writing up the quality of life data. IRAMMzB supervised and controlled the anaesthesiology protocol. NFMK, WW, JNMI, and EMMA coordinated the writing and drafting of the article. JNMI is guarantor. Ethical approval: This study was approved by the medical ethics committees of the university medical centres at Rotterdam and Nijmegen. Correspondence to: J N M IJzermans j.ijzermans@erasmusmc.nl We thank J G van Duuren-van Pelt, data manager, and I P J Alwayn, surgeon, for their contributions to this study. |
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| References_xml | – volume: 59 start-page: 673 year: 2002 article-title: Minimal incision living donor nephrectomy: improvement in patient outcome. publication-title: Urology contributor: fullname: Greenstein – volume: 19 start-page: 102 year: 2005 article-title: Laparoscopic donor nephrectomy vs open live donor nephrectomy: a quality of life and functional study. publication-title: Clin Transplant contributor: fullname: Hanaway – volume: 92 start-page: 44 year: 2005 article-title: Randomized clinical trial of open versus laparoscopic cholecystectomy in the treatment of acute cholecystitis. publication-title: Br J Surg contributor: fullname: Lundell – volume: 74 start-page: 1045 year: 2002 article-title: Right-sided laparoscopic live-donor nephrectomy: is reluctance still justified? publication-title: Transplantation contributor: fullname: IJzermans – volume: 169 start-page: 2018 year: 2003 article-title: Quality of life, pain and return to normal activities following laparoscopic donor nephrectomy versus open mini-incision donor nephrectomy. publication-title: J Urol contributor: fullname: Gritsch – volume: 72 start-page: 284 year: 2001 article-title: Randomized controlled trial of hand-assisted laparoscopic versus open surgical live donor nephrectomy. publication-title: Transplantation contributor: fullname: Punch – volume: 170 start-page: 738 year: 2003 article-title: Subcostal versus transcostal mini donor nephrectomy: is rib resection responsible for pain related donor morbidity. publication-title: J Urol contributor: fullname: Kumar – volume: 95 start-page: 851 year: 2005 article-title: Comparison of laparoscopic and open donor nephrectomy: a randomized controlled trial. publication-title: Br J Urolog Int contributor: fullname: Hosseini Moghaddam – volume: 80 start-page: 1060 year: 2005 article-title: Hand-assisted retroperitoneoscopic live donor nephrectomy: experience from the first 75 consecutive cases. publication-title: Transplantation contributor: fullname: Wadstrom – volume: 347 start-page: 989 year: 1996 article-title: Randomised, prospective, single-blind comparison of laparoscopic versus small-incision cholecystectomy. publication-title: Lancet contributor: fullname: Stoddard – volume: 81 start-page: 881 year: 2006 article-title: Donor nephrectomy: mini-incision muscle-splitting open approach versus laparoscopy. publication-title: Transplantation contributor: fullname: Ijzermans – volume: 79 start-page: 1236 year: 2005 article-title: Laparoscopic versus open living-donor nephrectomy: experiences from a prospective, randomized, single-center study focusing on donor safety. publication-title: Transplantation contributor: fullname: Line – volume: 16 start-page: 893 year: 2002 article-title: Technical considerations and pitfalls in laparoscopic live donornephrectomy. publication-title: Surg Endosc contributor: fullname: Weimar – volume: 73 start-page: 241 year: 1996 article-title: Application of the multidimensional fatigue inventory (MFI-20) in cancer patients receiving radiotherapy. publication-title: Br J Cancer contributor: fullname: de Haes – volume: 17 start-page: 589 year: 2004 article-title: A comparison of traditional open, minimal-incision donor nephrectomy and laparoscopic donor nephrectomy. publication-title: Transpl Int contributor: fullname: Nicholson – volume: 44 start-page: 1800 year: 2001 article-title: Functional outcome, quality of life, body image, and cosmesis in patients after laparoscopic-assisted and conventional restorative proctocolectomy: a comparative study. publication-title: Dis Colon Rectum contributor: fullname: Gouma – volume: 5 start-page: 2302 year: 2005 article-title: The Dutch national living donor kidney exchange program. publication-title: Am J Transplant contributor: fullname: Weimar – volume: 17 start-page: 591 year: 2003 article-title: Live donor nephrectomy and return to work: does the operative technique matter? publication-title: Surg Endosc contributor: fullname: Weimar – volume: 60 start-page: 1047 year: 1995 article-title: Laparoscopic live donor nephrectomy. publication-title: Transplantation contributor: fullname: Kavoussi – volume: 353 start-page: 447 year: 2005 article-title: Risks and benefits to the living donor. publication-title: N Engl J Med contributor: fullname: Ingelfinger |
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| Snippet | Abstract Objectives To determine the best approach for live donor nephrectomy to minimise discomfort to the donor and to provide good graft function. Design... Objectives To determine the best approach for live donor nephrectomy to minimise discomfort to the donor and to provide good graft function. Design Single... To determine the best approach for live donor nephrectomy to minimise discomfort to the donor and to provide good graft function. Single blind, randomised... Objectives: To determine the best approach for live donor nephrectomy to minimise discomfort to the donor and to provide good graft function. Design: Single... OBJECTIVESTo determine the best approach for live donor nephrectomy to minimise discomfort to the donor and to provide good graft function.DESIGNSingle blind,... Objectives To determine the best approach for live donor nephrectomy to minimise discomfort to the donor and to provide good graft function. Design Single... |
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| SubjectTerms | Abdomen Adult Aged Biological and medical sciences Blood & organ donations Blood donation Cholecystectomy Clinical trials Digestive system. Abdomen Endoscopy Fatigue Fatigue - etiology Female General aspects Graft Survival Hospitals Humans Investigative techniques, diagnostic techniques (general aspects) Kidneys Laparoscopy Laparoscopy - methods Length of Stay Living Donors Male Medical imaging Medical sciences Middle Aged Nephrectomy Nephrectomy - methods Nephrology Organ donation Pain Patient safety Patients Postoperative complications Postoperative Complications - etiology Quality of Life Self image Single-Blind Method Skin Statistical median Surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the urinary system Tissue grafting Transplants & implants Universities Veins & arteries |
| Title | Comparison of laparoscopic and mini incision open donor nephrectomy: single blind, randomised controlled clinical trial |
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