Objectives: Living donor surgeries are performed on healthy individuals, so it’s crucial that these procedures are carried out with the lowest possible risk and morbidity. After the surgery, it’s expected that donors should be able to return to their normal lives swiftly and without any permanent damage. In this study, we report our experiences with the new anterior less invasive crescentic donor nephrectomy technique.
Materials and Methods: We retrospectively evaluated 965 donor nephrectomy patients who had the new anterior less invasive crescentic incision (n = 436), the classic open (n = 431), or the laparoscopic living-donor nephrectomy (n = 98) procedures. Demographic characteristics, preoperative and postoperative parameters, acute renal graft dysfunction, and first year graft and patient survival rates were compared between groups.
Results: In preparation for surgery, the new crescentic incision provided a safe and comfortable position for the patient's positioning and the anesthesiologist's preparation for living donor nephrectomy. The position also facilitated grafts with multiple vessels. Patients had lower pain scores (P = .010), and shorter hospital stays (2.18 vs 3.49 days) than those who received the classic open living-donor nephrectomy. Patients who received laparoscopic living-donor nephrectomy had significantly longer mean operation time (P = .016) and warm ischemia time (P ≤ .001) than those who had the new cresentic incision technique. All groups showed similar rates of first-year survival and delayed graft dysfunction.
Conclusions: The new anterior less invasive crescentic incision open donor nephrectomy approach allows living donor nephrectomy to be performed safely. It is a more comfortable, effective, less time consuming and less invasive technique for patients. Also, it procures safe access for grafts with multiple vessels.