Trauma & Others(구연) (NP-070) 복강경 공여신절제술 후 배액관 미삽입은 술 후 이환율을 증가시키지 않는다 ¹울산대학교 의과대학 비뇨의학교실, ²아산생명과학연구원, ³외과학교실 안동현¹, 남욱¹, 장명진², 김경¹, 엄주민¹, 김영훈³, 한덕종³, 유달산¹ OBJECTIVES: Some authors addressed whether or not routine drainage is always necessary after partial nephrectomy or nephroureterectomy. However, the benefit of drainage versus their potential harm after laparoscopic donor nephrectomy has been questioned. Therefore, we conducted a comparative study to assess the need for routine drainage after laparoscopic donor nephrectomy. MATERIALS AND METHODS: A prospectively maintained database of 136 donor nephrectomies consecutively performed by a single surgeon (DY) from July 14, 2014 to November 24, 2017, was reviewed. Since October 5, 2016, we decided to omit routine drainage after surgery. The former 80 donor nephrectomies drained routinely (Drainage group) and the latter 56 intended not to drain (Non-drainage group). Laparoscopic donor nephrectomy was performed as previously described, with minor modifications, using the umbilical incision as the kidney extraction site. Operative and convalescence parameters, and intraoperative and postoperative complications were compared between the groups. Intraoperative and postoperative complications within 90 days of surgery were graded using the Satava and modified Clavien classifications, respectively. RESULTS: Baseline characteristics were similar in the two groups, except for American Society of Anesthesiologists score II (Drainage vs Non-drainage group=15.0% vs 48.2%; P<0.001). One patient in the Non-drainage group suffered from massive bleeding due to endoscopic stapler malfunction and drained unintentionally. There were no significant between-group differences in total operation time, warm ischemia time, visual analogue scale pain scores on postoperative day 1 and at discharge, and interval to return to a regular diet. The Drainage group showed less estimated blood loss (477.8 mL vs 614.3 mL; P=0.007), whereas the Non-drainage group showed shorter interval to removal of the drain (3.4 days vs 0.1 day; P<0.001) and overall hospital stay (5.4 days vs 4.9 days; P=0.026). The overall intraoperative complication rate was similar in the two groups (22.5% vs 30.4%; P=0.302). The overall postoperative complication rate was similar in the two groups (57.5% vs. 51.8%; P=0.510). CONCLUSIONS: Laparoscopic donor nephrectomy without routine drainage is feasible and safe. Donors not to drain might benefit from a shorter hospital stay without an increase in postoperative morbidity. keywords : Laparoscopic donor nephrectomy, Drainage, Complication