Srivastava Aneesh, Tripathi Dileep Mani, Zaman Wahid, Kumar Anant
Department of Urology and Renal Transplantation, Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Lucknow (U.P.)-226014 India.
J Urol. 2003 Sep;170(3):738-40. doi: 10.1097/01.ju.0000081649.53247.2d.
Conventional donor nephrectomy is associated with significant postoperative morbidity. Whether this morbidity is associated with rib resection or a long incision is not clear. We designed a prospective randomized study of subcostal and transcostal mini incision donor nephrectomy and compared the results.
We performed 82 donor nephrectomies in the study period of December 2000 to July 2001. Open donor nephrectomies were randomized to subcostal (25) or transcostal (24) mini incision techniques. Results were compared and analyzed using the independent t test.
The subcostal and transcostal groups were comparable in terms of patient age, body mass index, nephrectomy side, number of renal vessels and incision length (9.32 vs 9.72 cm). Patients in the subcostal group had a lesser postoperative analgesic requirement (304 +/- 49.8 vs 487 +/- 74.1 mg, p = 0.0001), shorter hospital stay (2.36 +/- 0.7 vs 3.71 +/- 0.81 days, p = 0.0001) and early convalescence (26.56 +/- 4.06 vs 37.46 +/- 6.05 days) compared with the transcostal group. Warm ischemia time and recipient outcome were similar in the groups.
Rib sparing, subcostal mini incision donor nephrectomy has significantly less morbidity and a shorter hospital stay compared with the rib resection transcostal technique.
传统供体肾切除术与显著的术后发病率相关。这种发病率是否与肋骨切除或长切口有关尚不清楚。我们设计了一项关于肋下和经肋微创切口供体肾切除术的前瞻性随机研究，并比较了结果。
在2000年12月至2001年7月的研究期间，我们进行了82例供体肾切除术。开放性供体肾切除术随机分为肋下（25例）或经肋（24例）微创技术。使用独立t检验对结果进行比较和分析。
肋下组和经肋组在患者年龄、体重指数、肾切除侧、肾血管数量和切口长度（9.32对9.72 cm）方面具有可比性。与经肋组相比，肋下组患者术后镇痛需求较少（304±49.8对487±74.1 mg，p = 0.0001），住院时间较短（2.36±0.7对3.71±0.81天，p = 0.0001），康复较早（26.56±4.06对37.46±6.05天）。两组的热缺血时间和受体结果相似。
与切除肋骨的经肋技术相比，保留肋骨的肋下微创切口供体肾切除术的发病率显著降低，住院时间更短。
