Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Clin Transplant. 2010 Sep-Oct;24(5):E182-7. doi: 10.1111/j.1399-0012.2009.01173.x.
To compare the outcome of hand-assisted laparoscopic live donor nephrectomy (HLDN) and total laparoscopic live donor nephrectomy (TLDN) in a single center.
The demographics, complications, and outcomes were compared between successfully performed 51 HLDN and 42 TLDN.
The patients' demographics including body mass index were all similar. Four conversions were excluded for the outcome analysis. The operation time of HLDN group (188 ± 62 min) was shorter, although not significantly, than that of TLDN group's (207 ± 30 min) (p = 0.065). However, the operation time of the first 24 cases (237 ± 66 min) was significantly longer than that of the later 69 performed (180 ± 35 min). The warm ischemia time was shorter in HLDN (2.5 ± 1.3 min) compared to that of TLDN (4.1 ± 1.7 min) (p < 0.01), but the serum creatinine values (mg/dL) of recipients were equivalent (HLDN/TLDN = 1.18 ± 0.3:1.14 ± 0.3, p = 0.587). There was no difference in the length of hospital stay (6.7 vs. 6.4 d, p = 0.475). There was no graft loss, but one ureter stricture (HLDN group) and one urinary leakage (TLDN group) were recorded.
Both HLDN and TLDN are effective and safe as reflected in graft functions and limited complications. There was a learning curve in establishing the technique of laparoscopic donor nephrectomy.
比较单中心手助腹腔镜活体供肾切取术（HLDN）与全腹腔镜活体供肾切取术（TLDN）的结果。
比较 51 例成功施行的 HLDN 与 42 例 TLDN 的患者人口统计学资料、并发症及结局。
患者的人口统计学资料（包括体重指数）均相似。4 例中转开腹手术者被排除在结局分析之外。HLDN 组的手术时间（188±62 min）虽然稍短，但无统计学意义（p=0.065）。然而，前 24 例（237±66 min）的手术时间明显长于后 69 例（180±35 min）。HLDN 的热缺血时间（2.5±1.3 min）较 TLDN （4.1±1.7 min）短（p＜0.01），但受者的血清肌酐值（mg/dL）相当（HLDN/TLDN=1.18±0.3∶1.14±0.3，p=0.587）。住院时间无差异（6.7 比 6.4 d，p=0.475）。无移植物丢失，但 HLDN 组有 1 例输尿管狭窄，TLDN 组有 1 例尿漏。
HLDN 和 TLDN 均有效且安全，表现在移植物功能和有限的并发症方面。腹腔镜供肾切取术技术的建立存在学习曲线。
