Trauma & Others(구연) (NP-071) 왼쪽신장 공여 시 고전적 복강경 공여신절제술에서 포트감량 복강경 공여신절제술로의 전환 ¹울산대학교 의과대학 비뇨의학교실, ²아산생명과학연구원, ³외과학교실 남욱¹, 안동현¹, 장명진², 김경¹, 엄주민¹, 김영훈³, 한덕종³, 유달산¹ OBJECTIVES: We compared perioperative donor outcomes of conventional laparoscopic donor nephrectomy (CLDN) and reduced-port laparoscopic donor nephrectomy (RPLDN) performed in left allograft, to define the feasibility of technical transition from CLND to RPLDN. 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. In 75 donors of them, left kidney was procured. The former 29 donor nephrectomies were performed by CLND and the latter 46 by RPLND. Of 46 RPLND, only 17 cases performed before further technical modification (without drainage) were included for analysis. For CLDN, about 6-cm omega-shaped incision was made around the umbilicus for insertion of the wound retractor. A second 12-mm trocar was placed below the left costal margin in the left midclavicular line and a third 12-mm trocar was placed between the umbilicus and anterior superior iliac spine in the left anterior axillary line. Finally, a 5-mm trocar for assistant was placed approximately 2 cm from the tip of the left 12th rib. For RPLND, a 5-mm trocar was omitted. 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. There were no significant between-group differences in warm ischemia time, estimated blood loss, visual analogue scale pain scores at discharge, and interval to return to a regular diet. The RPLND group showed shorter total operation time (CLND vs RPLND group=182.3 minutes vs 158.4 minutes; P=0.002), shorter interval to removal of the drain (3.7 days vs 2.8 days; P=0.004), overall hospital stay (5.8 days vs 4.6 days; P=0.001) and lower visual analogue scale pain scores on postoperative day 1 (4.6 vs 3.5; P=0.046). The overall intraoperative complication rate was similar in the two groups (27.6% vs 17.6%; P=0.501). The overall postoperative complication rate was similar in the two groups (58.6% vs. 41.2%; P=0.253). CONCLUSIONS: The technical transition from CLDN to RPLDN is feasible and safe with a relatively short learning curve for surgeons mastering CLND. keywords : Laparoscopic donor nephrectomy, Reduced-port, Left allograft