Flank versus subcostal incision in kidney donors: a randomized clinical trial

Abstract

Objective: To compare flank versus subcostal incision in kidney donors considering surgery and hilum dissection duration, as well as difficulty and conditions of the graft during harvesting and after transplantation. Post-operative complications, hospital stay and postoperative pain were also compared. Methods: Twenty-six consecutive kidney donors were evaluated in a prospective and randomized manner, comparing flank and anterior subcostal incision, being 15 in the first (group 1 - flank incision) and 11 in the latter (group 2 - anterior subcostal incision). Results: Average surgery length was similar, 175 versus 176 minutes respectively, although difficulty and dissection time of the hilum were greater in group 02 (44.3 versus 50 minutes). Reperfusion was better in the group 1 than in the group 2. The length of hospitalization was similar in both groups (4.4 and 4.2 days respectively). The group 2 had more postoperative pain than group 1. Conclusions: Although flank incision had better results, the subcostal incision still have to be considered, mainly in cases of vascular anomalies and chronic obstructive pulmonary disease.