Skripsi

Analisis Perbandingan Komplikasi Laparoscopic Living Donor Nephrectomy dengan Pendekatan Transperitoneal dan Retroperitoneal berdasarkan kriteria Clavien-Dindo Classification di RSCM = Comparative Analysis of Complications in Laparoscopic Living Donor Nephrectomy Using Transperitoneal and Retroperitoneal Approaches Based on the Clavien-Dindo Classification at RSCM.

Latar Belakang Laparoscopic Living Donor Nephrectomy (LLDN) dapat dilakukan dengan pendekatan transperitoneal atau retroperitoneal. Kedua pendekatan ini memiliki perbedaan akses intraabdominal yang berpotensi memengaruhi tingkat komplikasi pascaoperasi. Clavien-Dindo Classification (CDC) digunakan sebagai sisem penilaian tingkat komplikasi secara objektif. Metode Penelitian ini merupakan studi retrospektif cross-sectional yang membandingkan komplikasi antara pendekatan transperitoneal dan retroperitoneal pada prosedur Laparoscopic Living Donor Nephrectomy (LLDN) menggunakan klasifikasi Clavien-Dindo. Subjek dibagi menjadi dua kelompok sesuai pendekatan operasi. Karakteristik dasar donor disajikan secara deskriptif dalam bentuk tabel dan diamati tanpa dilakukan uji statistik. Komplikasi pascaoperasi diklasifikasikan menggunakan sistem Clavien-Dindo, serta dilakukan analisis subkelompok menggunakan uji Chi-Square. Hasil Kumpulan data rekam medis 1085 pasien selama 14 tahun (2011-2025) di Rumah Sakit dr.Cipto Mangunkusumo (RSCM) telah dianalisis (397 retroperitoneal, 688 transperitoneal). Tidak terdapat perbedaan signifikan pada karakteristik dasar kedua kelompok, kecuali kelompok retroperitoneal memiliki indeks massa tubuh dan usia lebih tinggi. Berdasarkan CDC, kelompok retroperitoneal menunjukkan 93,7% bebas komplikasi, 5,0% komplikasi minor, dan 1,3% komplikasi mayor. Kelompok transperitoneal memiliki 96,2% bebas komplikasi, 3,0% komplikasi minor, dan 0,7% komplikasi mayor. Perbedaan tersebut tidak bermakna secara statistik. Kesimpulan Pendekatan LLDN transperitoneal dan retroperitoneal di RSCM menunjukkan tingkat komplikasi pascaoperasi yang sama-sama rendah berdasarkan Klasifikasi Clavien-Dindo, sehingga keduanya aman untuk dilakukan.
Kata Kunci: Laparoscopic Living Donor Nephrectomy (LLDN), transperitoneal, retroperitoneal, Clavien-Dindo Classification, komplikasi pascaoperasi.


Introduction Laparoscopic Living Donor Nephrectomy (LLDN) can be performed via either a transperitoneal or retroperitoneal approach. These approaches differ in intra-abdominal access, which may influence postoperative complication rates. The Clavien-Dindo Classification (CDC) is an objective system for grading the severity of surgical complications. Methods This retrospective cross-sectional study compared complications between transperitoneal and retroperitoneal LLDN performed at Dr. Cipto Mangunkusumo National General Hospital (RSCM) from 2011 to 2025. Subjects were divided into two groups according to the surgical approach. Donor baseline characteristics were presented descriptively in tabular form and observed without statistical testing. Postoperative complications were classified using the Clavien-Dindo system, with subkelompok analysis performed using the Chi-square test. Result A total of 1,085 patients were included (397 retroperitoneal, 688 transperitoneal). Observation of baseline characteristics indicated that the retroperitoneal group tended to have higher body mass index and older age. Based on CDC grading, the retroperitoneal group had 93.7% with no complications, 5.0% with minor complications, and 1.3% with major complications. The transperitoneal group had 96.2% with no complications, 3.0% with minor complications, and 0.7% with major complications. These differences were not statistically significant. Conclusion Based on this study, both transperitoneal and retroperitoneal LLDN at RSCM demonstrated similarly low postoperative complication rates according to the Clavien-Dindo Classification, indicating that both approaches are safe to perform. Surgical approach selection may be tailored to patient condition and surgeon experience. Further prospective multicenter studies with long-term follow-up are recommended to confirm these findings and assess outcomes beyond the early postoperative period.
Keywords: Laparoscopic Living Donor Nephrectomy, transperitoneal approach, retroperitoneal approach, Clavien-Dindo Classification, postoperative complications