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Myltykbay Rysmakhanov,Asset Yelemessov,Nadiar Mussin,Daulet Yessenbayev,Samat Saparbayev,Bazylbek Zhakiyev,Yerlan Sultangereyev 대한이식학회 2022 Korean Journal of Transplantation Vol.36 No.2
Background: This is the first report on three-dimensional (3D) laparoscopic donor nephrectomy performed in the Central Asian region and Commonwealth of Indepen- dent States countries. This study presents the results of our initial experiences of 3D hand-assisted laparoscopic donor nephrectomy (3D-HALDN) in comparison with the outcomes of two-dimensional hand-assisted laparoscopic donor nephrectomy (2D-HALDN) at a single center. Methods: From 2015 to 2019, 19 3D-HALDN and 19 2D-HALDN procedures were per- formed at the same center by two surgeons. All 38 procedures used identical tech- niques. Between-group differences were considered statistically significant at P<0.05. Results: The baseline characteristics in both groups were statistically comparable (P>0.05). All donors underwent left nephrectomy. Donors who underwent 3D-HALDN had better outcomes than those who underwent 2D-HALDN, as shown by a shorter warm ischemic time (P<0.05), a shorter operative time (P<0.05), and less blood loss (P<0.05). There were no conversions or major complications (according to the Clavien-Dindo classification) in either group. The average drainage duration and postoperative hospital- ization were significantly shorter in the 3D-HALDN group (P<0.05). The between-group differences in the mean postoperative creatinine level and glomerular filtration rate were not significant. Conclusions: The 3D-HALDN approach is more beneficial than traditional 2D-HALDN by providing a shorter warm ischemic time, less blood loss, and shorter durations of drain- age and postoperative hospitalization. Postoperative complications and the functional condition of the kidney in donors in the early and late postoperative periods did not de- pend on the type of laparoscopic donor nephrectomy.