Lee Kyu-Sung, Hong Jeong Hee, Jeon Seong Soo, Choi Han Yong, Kim Sung Joo, Lee Sung Won
Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
J Endourol. 2007 Aug;21(8):866-71. doi: 10.1089/end.2006.0463.
Laparoscopic donor nephrectomy is associated with decreased morbidity while maintaining similar graft function in short-term follow-up compared with open surgery. We investigated hand-assisted laparoscopic donor nephrectomy (HALDN) in comparison with standard open donor nephrectomy (ODN) in living donors.
Two hundred patients who received a living-donor kidney and were followed up for more than 1 year were enrolled. The procedure was performed exclusively on the left kidney through either HALDN or ODN from January 2001 to July 2004. The probability of graft survival was determined using the Kaplan-Meier method. Multivariate analysis using a Cox regression hazard model was performed to identify the predictors of graft survival.
The mean operative time, estimated blood loss, warm ischemic time, and operation-related complications were compared. There was no difference in graft function. The cumulative graft survival at 1 and 3 years was similar in the two groups: 98% and 97%. Episodes of acute rejection were an independent predictor of graft survival.
Hand-assisted laparoscopic nephrectomy in living donors is safe and effective with results similar to those of open nephrectomy with regard to graft function.
与开放手术相比，腹腔镜供肾切除术在短期随访中可降低发病率，同时维持相似的移植肾功能。我们对活体供者的手辅助腹腔镜供肾切除术（HALDN）与标准开放供肾切除术（ODN）进行了比较研究。
纳入200例接受活体供肾且随访超过1年的患者。2001年1月至2004年7月期间，仅通过HALDN或ODN对左肾进行手术操作。采用Kaplan-Meier法确定移植肾存活概率。使用Cox回归风险模型进行多因素分析，以确定移植肾存活的预测因素。
比较了平均手术时间、估计失血量、热缺血时间和手术相关并发症。移植肾功能无差异。两组1年和3年的累积移植肾存活率相似：分别为98%和97%。急性排斥反应是移植肾存活的独立预测因素。
活体供者手辅助腹腔镜肾切除术安全有效，在移植肾功能方面与开放肾切除术效果相似。
