Maciel R F, Deboni L M, Guterres J C, Branco A J, Branco A W, Silva A E, Ramos L, Vieira J A
Department of Surgery and Transplantation, Fundacão Prorim de Santa Catarina, Hospital Municipal São José de Joinville, Joinville, Brazil.
Transplant Proc. 2005 Jul-Aug;37(6):2748-9. doi: 10.1016/j.transproceed.2005.06.089.
The objective of this study was to compare two surgical approaches for living donor nephrectomy: transperitoneal anterior approach and the hand-assisted laparoscopic nephrectomy. Between January 2001 and October 2003 we performed 63 kidney transplantations from living donors. The transperitoneal anterior approach was used in 36 cases and the hand-assisted laparoscopic nephrectomy in 27. Outcomes were compared in terms of hospital stay, postoperative analgesia, and graft quality. Mean hospital stay was 4.7 days in the transperitoneal anterior approach group and 3.7 days in the hand-assisted laparoscopic group (P < .005). Postoperative analgesia dosage was significantly lower in the hand-assisted laparoscopic group (P < .001). Surgical complications and graft quality were similar. We concluded that hand-assisted laparoscopic nephrectomy patients had shorter hospital stays and less pain in the postoperative period, with better cosmetic results and equivalent graft quality compared to transperitoneal anterior approach patients.
经腹前路手术和手辅助腹腔镜肾切除术。在2001年1月至2003年10月期间，我们进行了63例活体供肾肾移植手术。其中36例采用经腹前路手术，27例采用手辅助腹腔镜肾切除术。从住院时间、术后镇痛情况和移植物质量方面对结果进行了比较。经腹前路手术组的平均住院时间为4.7天，手辅助腹腔镜组为3.7天（P <.005）。手辅助腹腔镜组的术后镇痛剂量显著较低（P <.001）。手术并发症和移植物质量相似。我们得出结论，与经腹前路手术患者相比，手辅助腹腔镜肾切除术患者的住院时间更短，术后疼痛更少，美容效果更好，移植物质量相当。
