Department of Infection, Immunity and Inflammation, University of Leicester, Leicester General Hospital, Leicester, UK.
Transplantation. 2011 Feb 27;91(4):457-61. doi: 10.1097/TP.0b013e318204bdf7.
The aim of this study was to compare patient-reported health status and quality of life after randomization to laparoscopic donor nephrectomy (LDN) or short-incision open donor nephrectomy (ODN).
Live kidney donors were randomized in a 2:1 ratio to LDN (n=56) or ODN (n=28). Health-related quality of life was assessed using the Short Form 36 questionnaire preoperatively and at 6 weeks postdonation.
Postoperative morphine requirement was lower in the LDN group (median [range], 59 [6-136]) versus ODN group (90 [35-312] mg; P=0.001). Norm adjusted physical components scores decreased significantly at 6 weeks in both the LDN and ODN groups. The bodily pain domain score of physical components score at 6 weeks returned to baseline in the laparoscopic group (86.4±19.8 vs. 81.8±15.9; P=0.2277) but not in the open group (87.3±18.3 vs. 69.0±25.0; P=0.05). The mental component score decreased in the ODN group (53.5±7.6 vs. 45.3±10.1; P=0.0084) but returned to baseline 6 weeks after LDN (53.8±6.5 vs. 51.9±7.2; P=0.2931).
Donors undergoing laparoscopic nephrectomy reported less bodily pain in the first 6 weeks postdonation, and this was associated with an improved mental health component of quality of life compared with ODN (51.9±7.2 vs. 45.3±10.1; P=0.0009).
本研究旨在比较随机分配至腹腔镜供肾切除术（LDN）或短切口开放供肾切除术（ODN）后患者报告的健康状况和生活质量。
将活体供肾者以 2:1 的比例随机分配至 LDN（n=56）或 ODN（n=28）组。使用简短 36 问卷在术前和术后 6 周评估健康相关生活质量。
LDN 组术后吗啡需求量低于 ODN 组（中位数[范围]，59[6-136]mg 比 90[35-312]mg；P=0.001）。LDN 和 ODN 组术后 6 周时，体质健康状况的生理成分评分均显著下降。腹腔镜组术后 6 周时，生理成分评分的身体疼痛域评分恢复至基线（86.4±19.8 比 81.8±15.9；P=0.2277），但开放组未恢复至基线（87.3±18.3 比 69.0±25.0；P=0.05）。ODN 组的心理成分评分下降（53.5±7.6 比 45.3±10.1；P=0.0084），但 LDN 术后 6 周时恢复至基线（53.8±6.5 比 51.9±7.2；P=0.2931）。
与 ODN 相比，接受腹腔镜肾切除术的供者在术后 6 周内报告的身体疼痛更少，且与心理健康成分的生活质量改善相关（51.9±7.2 比 45.3±10.1；P=0.0009）。
