Diner Eric K, Radolinski Bartholomew, Murdock Jonah D, Ghasemian S Reza
Department of Urology, Washington Hospital Center, Washington, DC 20010, USA.
Urology. 2006 Dec;68(6):1175-7. doi: 10.1016/j.urology.2006.08.1076.
To review 167 consecutive laparoscopic living donor nephrectomies performed at the Washington Hospital Center to determine whether the side of extraction, right versus left, affects the operative outcomes.
From January 2003 to June 2005, 167 consecutive patients (127 left and 40 right) underwent laparoscopic living donor nephrectomy. The right-sided and left-sided procedures were compared in the following categories: operative time, warm ischemia time, length of stay, and complications.
The mean operative time for a right donor nephrectomy was 220 minutes versus 228 minutes for a left. The mean estimated blood loss was 115 mL for right donor nephrectomy versus 106 mL for the left. The corresponding mean warm ischemia times were 5.32 minutes and 4.91 minutes. The median length of stay was 3 days in both groups. Five minor and three major complications occurred, including 2 patients with recognized bowel injuries and 1 patient who required reoperation for a bladder injury.
Historically, laparoscopic living donor nephrectomy has been performed solely on the left side because of the increased length of the left renal vein. However, in our experience, the operative parameters and postoperative results were equivalent in the right and left laparoscopic donor nephrectomy groups. Therefore, we recommend removal of the more appropriate kidney, regardless of side.
回顾华盛顿医院中心连续进行的167例腹腔镜活体供肾切除术，以确定摘取侧（右侧与左侧）是否会影响手术结果。
2003年1月至2005年6月，167例连续患者（127例左侧，40例右侧）接受了腹腔镜活体供肾切除术。对右侧和左侧手术在以下方面进行比较：手术时间、热缺血时间、住院时间和并发症。
右侧供肾切除术的平均手术时间为220分钟，左侧为228分钟。右侧供肾切除术的平均估计失血量为115毫升，左侧为106毫升。相应的平均热缺血时间分别为5.32分钟和4.91分钟。两组的中位住院时间均为3天。发生了5例 minor和3例 major并发症，包括2例确诊的肠损伤患者和1例因膀胱损伤需要再次手术的患者。
从历史上看，由于左肾静脉较长，腹腔镜活体供肾切除术一直仅在左侧进行。然而，根据我们的经验，右侧和左侧腹腔镜供肾切除术组的手术参数和术后结果相当。因此，我们建议摘取更合适的肾脏，而不论其侧别。
