Comparison of Pfannenstiel or Extended Iliac Port Site Kidney Extraction in Laparoscopic Donor Nephrectomy: Do We Have Consensus?

Experimental and clinical transplantation 2017; 15(2): 138-142.

Aims
To compare the outcomes of extended iliac port site (EP) incision versus Pfannenstiel incision for kidney extraction in laparoscopic donor nephrectomy (LDN).

Interventions
Participants undergoing LDN were randomised for kidney extraction either by EP incision or Pfannenstiel incision.

Participants
41 patients undergoing LDN at Ramathibodi Hospital in Bangkok.

Outcomes
Outcomes measured included perioperative blood loss, operative time, warm ischemic time, perioperative complications, postoperative analgesic requirement, length of hospital stay, and cosmetic outcomes which included physical characteristics, cosmetic appearance, and patient’s symptoms.

Follow-up
6 months

CET Conclusions
This is a small RCT of 2 extraction sites for the kidney in live donor nephrectomy. The authors found a shorter warm ischaemic time (by almost a minute) when using an extended iliac port site rather than a pfannenstiel incision. This is contrary to other recently published studies and represents a difference in the method of extraction (with port and camera vision versus without port and blind) rather than the site of extraction in my opinion; it is possible to place a port through a pfannenstiel incision to allow laparoscopic gripping and visualisation as the kidney is removed. There are missing quality and bias indicators in this report and I do not see this study changing individual surgeons’ practice.

Jadad score
1

Data analysis
Per protocol analysis

Allocation concealment
No

Trial registration
None

Funding source
Not reported