Mehmet DOKUR, Erdal UYSAL, M. Fatih YÜZBAŞIOĞLU, Mesut SİPAHİ, Başar AKSOY

CANLI DONÖR RENAL TRANSPLANTASYONLARDA LAPAROSKOPİK VE AÇIK DONÖR NEFREKTOMİNİN KARŞILAŞTIRILMASI

Amaç: Çalışmamızda merkezimizde yapılan açık ve laparoskopik donor nefrektomi sonuçlarını karşılaştırmakve deneyimlerimizi aktarmak amaçlanmıştır.Metod: Merkezimizde 2011- 2015 yılları arasında yapılan laparoskopik ve açık donor nefrektomi uygulananhastalar çalışmaya alındı. Hastaların verilerine retrospektif olarak dosya kayıtlarından ulaşıldı. Demografik özel- likler, hastanede kalış süresi, operasyon süresi, sıcak iskemi süresi, gecikmiş graft fonksiyonları, komplikasyon- lar gibi parametreler karşılaştırıldı.Bulgular: Donörlerin %26,6sına laparoskopik donör nefrektomi, %73,4üne açık donor nefrektomi uygulan- dı. Perioperatif donör verileri karşılaştırıldığında hastanede kalış süreleri, ameliyat süreleri, maliyet ve donörolarak seçilen böbrek tarafları açısından istatistiksel anlamlılık saptandı (p0.05). Gecikmiş graft fonksiyonu her iki gruptada da görülmedi. Her ikigruptan birer alıcıda akut rejeksiyon gelişti. Sonuç: Kısa hastanede kalış süresi düşük komplikasyon oranı ile laparoskopik donör nefrektomi açık yöntemegöre avantaj sağlamaktatır. Uzamış operasyon süresi, artmış sıcak iskemi süresi ve deneyim gerektirmesi gibidezavantajlarına rağmen uzun dönemli graft fonksiyonlarını etkilememesi ve sayılan avantajlarından dolayıaçık donör nefrektomiye tercih olarak görülebilir.

Comparison of Laparoscopic and Open Donor Nephrectomy on Living Donor Renal Transplantations

Aim: Comparisons between open and laparoscopic donor nephrectomy results as well as sharing theexperiences of our clinic had been aimed in our study.Method: The study comprised of the patients who underwent laparoscopic and open donor nephrectomyin our center between 2011 and 2015. Patient findings were retrieved retrospectively from their files. Theparameters such as demographic features, duration of hospital stay, duration of operation, duration of hotischemia, related graft functions, and complications had been compared.Findings: 26,6% of the donors underwent laparoscopic donor nephrectomy, and 73,4% of the donorsunderwent open donor nephrectomy. Comparison of the perioperative donor data revealed statisticalsignificance in durations of hospital stay, durations of surgery, cost and chosen kidney sides. No significancehad been detected among the creatinine levels in postoperative first days. Renal artery injury had happenedto one patient who was in the laparoscopic donor nephrectomy group. No vessel injuries were observed in theopen donor nephrectomy group. While no minor complications had been observed in the laparoscopic donornephrectomy group, minor complications had been observed in 7 patients in the open donor nephrectomygroup. No statistical significance had been detected between creatinine values on postoperative 7th and 30thdays on the receivers. Belated graft function was not seen in both groups. Acute rejection had been developedin one receiver from both groups. Result: Laparoscopic donor nephrectomy has an advantage over the open method with short durationof hospital stay and low complication rate. Despite its disadvantages such as extended operation period,increased hot ischemia period and experience requisition, it might be seen as a choice against open donornephrectomy due to its mentioned advantages and not affecting long term graft functions.

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