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活体供肾肾切除术:侧腹切口与前正中垂直小切口对比

Living donor nephrectomy: flank incision versus anterior vertical mini-incision.

作者信息

Neipp Michael, Jackobs Steffan, Becker Thomas, zu Vilsendorf Andreas Meyer, Winny Markus, Lueck Rainer, Klempnauer Juergen, Nashan Björn

机构信息

Department of Transplantation, Medizinische Hochschule Hannover, Hannover, Germany.

出版信息

Transplantation. 2004 Nov 15;78(9):1356-61. doi: 10.1097/01.tp.0000140975.96729.a7.

Abstract

BACKGROUND

Currently, many centers perform laparoscopic donor nephrectomy (DN). We studied the outcome of donors and recipients following open DN using either flank incision (ODN) or mini-incision (MIDN).

METHODS

Data of 196 living kidney donors were recorded prospectively. In 127 cases ODN and 69 cases MIDN were performed.

RESULTS

Demographic details of donors were comparable for both groups. The left kidney was procured in 58% for ODN and in 64% for MIDN. Multiple arteries were more frequently present when MIDN (11% vs. 28%) was performed. The mean operating time was 129 min for ODN and 133 min for MIDN. Early complications occurred in 7% following ODN and in 4% following MIDN. Late complications were observed in 21% after ODN and 1% after MIDN. The mean hospital stay was significantly longer following ODN compared with MIDN (7.5 vs. 6.4 days). The primary graft function rate was 97% in both groups. One-year graft survival was 97% after ODN and 100% after MIDN.

CONCLUSIONS

Results following MIDN are superior to those following ODN. Even in case of multiple renal vessels MIDN can be safely applied. In comparison with laparoscopic DN advantages of MIDN may be reduced costs, shorter operating time, and comparable cosmetic results.

摘要

背景

目前,许多中心都在开展腹腔镜供肾切除术(DN)。我们研究了采用侧腹切口开放性供肾切除术(ODN)或小切口开放性供肾切除术(MIDN)后供者和受者的结局。

方法

前瞻性记录了196例活体肾供者的数据。其中127例行ODN,69例行MIDN。

结果

两组供者的人口统计学细节具有可比性。ODN组58%获取的是左肾,MIDN组为64%。行MIDN时多支动脉出现的频率更高(11%对28%)。ODN的平均手术时间为129分钟,MIDN为133分钟。ODN后7%发生早期并发症,MIDN后为4%。ODN后21%出现晚期并发症,MIDN后为1%。与MIDN相比,ODN后的平均住院时间显著更长(7.5天对6.4天)。两组的移植肾初期功能率均为97%。ODN后1年移植肾存活率为97%,MIDN后为100%。

结论

MIDN的结果优于ODN。即使存在多支肾血管,MIDN也可安全应用。与腹腔镜DN相比,MIDN的优势可能在于成本降低、手术时间缩短以及美容效果相当。

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