TY - JOUR T1 - Hand-assisted laparoscopic living-donor nephrectomy as an alternative to traditional laparoscopic living-donor nephrectomy JF - Am J Transplant Y1 - 2002 A1 - Buell,J. F. A1 - Hanaway,M. J. A1 - Potter,S. R. A1 - Cronin,D. C. A1 - Yoshida,A. A1 - Munda,R. A1 - Alexander,J. W. A1 - Newell,K. A. A1 - Bruce,D. S. A1 - Woodle,E. S. KW - *Living Donors KW - Activities of Daily Living KW - Comparative Study KW - Costs and Cost Analysis KW - Humans KW - Kidney Transplantation / methods / physiology KW - Laparoscopy / economics / *methods KW - Length of Stay KW - Nephrectomy / economics / *methods KW - Ohio KW - Pain, Postoperative / drug therapy / epidemiology KW - Posture KW - Time Factors AB - The benefits of laparoscopic living-donor nephrectomy (LDN) are well described, while similar data on hand-assisted laparoscopic living-donor nephrectomy (HALDN) are lacking. We compare hand-assisted laparoscopic living-donor nephrectomy with open donor nephrectomy. One hundred consecutive hand-assisted laparoscopic living-donor nephrectomy (10/98-8/01) donor/recipient pairs were compared to 50 open donor nephrectomy pairs (8/97-1/00). Mean donor weights were similar (179.6 +/- 40.8 vs. 167.4 +/- 30.3 lb; p = NS), while donor age was greater among hand-assisted laparoscopic living-donor nephrectomy (38.2 +/- 9.5 vs. 31.2 +/- 7.8 year; p < 0.01). Right nephrectomies was fewer in hand-assisted laparoscopic living-donor nephrectomy [17/100 (17%) vs. 22/50 (44%); p < 0.05]. Operative time for hand-assisted laparoscopic living-donor nephrectomy (3.9 +/- 0.7 vs. 2.9 +/- 0.5 h; p < 0.01) was longer; however, return to diet (6.9 +/- 2.8 vs. 25.6 +/- 6.1 h; p < 0.01), narcotics requirement (17.9 +/- 6.3 vs. 56.3 +/- 6.4h; p < 0.01) and length of stay (51.7 +/- 22.2 vs. 129.6 +/- 65.7 h; p < 0.01) were less than open donor nephrectomy. Costs were similar ($11072 vs. 10840). Graft function and 1-week Cr of 1.4 +/- 0.9 vs. 1.6 +/- 1.1 g/dL (p = NS) were similar. With the introduction of HALDN, our laparoscopic living-donor nephrectomy program has increased by 20%. Thus, similar to traditional laparoscopic donor nephrectomy, hand-assisted laparoscopic living-donor nephrectomy provides advantages over open donor nephrectomy without increasing costs. VL - 2 CP - 10 N1 - 1600-6135 (Print) Clinical Trial Controlled Clinical Trial Journal Article ID - 245 ER -