Han W K, Lee H Y, Jeon H G, Joo D J, Rha K H, Yang S C
Yonsei University College of Medicine, Urological Science Institute, Seoul, Korea.
Transplant Proc. 2010 Jun;42(5):1479-83. doi: 10.1016/j.transproceed.2010.01.070.
This study compared open and video-assisted minilaparotomy surgery in live kidney donors for quality of life (QoL), pain, cosmesis, and recovery. Between January 2003 and March 2006, we reviewed data from 205 patients who underwent live-donor nephrectomy: 116 by video-assisted minilaparotomy and 89 by open surgery. Pain and satisfaction were evaluated using scales from 1 to 10, and QoL, with the 36-item Short Form questionnaire. Hospital stay was significantly shorter among the video-assisted (5.1 +/- 1.6 days) than the open group (6.9 +/- 1.3 days; P < .01). Time to resumption of walking without difficulty and normal activity was significantly shorter among the video-assisted than the open group (P<.01). The video-assisted group showed better QoL scores in 6 of 8 QoL categories, including physical role (P < .01), bodily pain (P < .01), general health (P < .01), vitality (P < .01), emotional health (P < .01), and mental health (P < .01). Patients in the video-assisted group (score, 7.3 +/- 2.4) were more satisfied with the cosmetic outcome than those in the open group (score, 5.1 +/- 3.0; P < .01). In conclusion, donors who underwent nephrectomy via video-assisted minilaparotomy showed better outcomes regarding pain, convalescence, cosmesis, and QoL than those who underwent open surgery.
本研究比较了活体肾供体中开放性手术和电视辅助小切口剖腹手术在生活质量（QoL）、疼痛、美观及恢复方面的情况。2003年1月至2006年3月期间，我们回顾了205例行活体供肾肾切除术患者的数据：116例接受电视辅助小切口剖腹手术，89例接受开放性手术。使用1至10分的量表评估疼痛和满意度，并采用36项简明健康调查问卷评估生活质量。电视辅助手术组的住院时间（5.1±1.6天）明显短于开放手术组（6.9±1.3天；P<.01）。电视辅助手术组在无需帮助行走和恢复正常活动方面的时间明显短于开放手术组（P<.01）。电视辅助手术组在8个生活质量类别中的6个类别中显示出更好的生活质量评分，包括身体功能（P<.01）、身体疼痛（P<.01）、总体健康（P<.01）、活力（P<.01）、情感健康（P<.01）和精神健康（P<.01）。电视辅助手术组患者（评分7.3±2.4）对美容效果的满意度高于开放手术组患者（评分5.1±3.0；P<.01）。总之，与接受开放性手术的供体相比，接受电视辅助小切口剖腹手术的供体在疼痛、康复、美观及生活质量方面的结果更好。
