Mini-incisions by lombotomy or subcostal access in living kidney donors: a randomized trial comparing pain, safety, and quality of life

Mini-incisions by lombotomy or subcostal access in living kidney donors: a randomized trial comparing pain, safety, and quality of life

Author Aguiar, Wilson Ferreira Google Scholar
Passerotti, Carlo Camargo Google Scholar
De Almeida Claro, Joaquim Francisco Google Scholar
Almeida, Claudio Jose Ramos Google Scholar
Gattas, Nelson Google Scholar
Cedenho, Agnaldo Pereira Google Scholar
Pestana, Jose Osmar Medina Google Scholar
Ortiz, Valdemar Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Objectives: the aim of this study was to compare two mini-incision techniques and judge the impact on the quality of life, pain, and safety of living kidney donors.Patients and methods: From March through September 2003, a prospective randomized study with 60 donors had nephrectomy performed - 30 through a lombotomy and another 30 patients underwent subcostal mini-incisions. the same anesthetic procedure was used for both groups. All patients were evaluated from baseline (T0) to day 90 after surgery. Pain evaluation included visual analog scale (VAS) and drug usage. To assess quality of life (QOL), the questionnaire SF-36 was used and surgical outcomes were also checked.Results: Sixty patients (41.6 +/- 8.9 yr old) were included in the protocol. Regarding incision length and blood loss, no statistical difference was observed. However, irrespective to the site of the mini-incision, patients with body mass index (BMI) higher than 25 kg/m(2) had significantly longer incision length as well as higher blood loss. There were no complications. No significant difference in tramadol or in pain perception was observed between groups. QOL was also not different between groups, however, there was a significant loss with subsequent return to baseline levels.Conclusion: the position of the mini-incision (lombotomy or subcostal) has no significant impact on surgical outcomes, pain perception, and QOL of living kidney donors. Mini-incision techniques represent fast and safe approaches to perform nephrectomy in the healthy population. Special care must be taken in obese patients in order to minimize surgical complications.
Keywords kidney transplantation
living donor
lombotomy
mini-incision
pain
quality of life
safety
subcostal
Language English
Date 2007-03-01
Published in Clinical Transplantation. Oxford: Blackwell Publishing, v. 21, n. 2, p. 269-276, 2007.
ISSN 0902-0063 (Sherpa/Romeo, impact factor)
Publisher Blackwell Publishing
Extent 269-276
Origin http://dx.doi.org/10.1111/j.1399-0012.2006.00638.x
Access rights Closed access
Type Article
Web of Science ID WOS:000245229800020
URI http://repositorio.unifesp.br/handle/11600/29583

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