Patel Sutchin R, Kaplon Daniel M, Moon Timothy D, Hedican Sean P, Nakada Stephen Y
Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792-7375, USA.
JSLS. 2011 Apr-Jun;15(2):203-7. doi: 10.4293/108680811X13071180406556.
To evaluate outcomes for simple hand-assisted laparoscopic nephrectomy (HALSN).
A retrospective chart review was performed at our institution for all patients who had undergone HALSN from January 2002 to January 2009. Thirty-three patients underwent HALSN during this time period and were matched with 33 patients who underwent radical handassisted laparoscopic nephrectomy (HALRN).
Operative times were similar between both groups (301 vs 286 min for HALSN vs HALRN; P=.54). There were no intraoperative or postoperative transfusions in either group. There was one conversion to open nephrectomy in the HALSN group in a patient with xanthogranulomatous pyelonephritis and no conversions in the HALRN group. The mean opioid equivalence requirement was not statistically different between both groups (110 vs 120 for HALSN vs HALRN, P=.70). Mean hospital stay was similar for patients undergoing HALSN and HALRN (5.0±3.8 days vs 4.0±1.2 days, P=.63). There was 1 major complication in the HALSN group (pulmonary embolus) and no major complications in the HALRN group. Rates of minor complications were comparable between the 2 groups (18% vs 24% for HALSN vs HALRN).
HALSN may be associated with similar operative times and length of postoperative hospital stay as well as comparable complication rates compared to HALRN.
评估单纯手辅助腹腔镜肾切除术（HALSN）的治疗效果。
对我院2002年1月至2009年1月期间所有接受HALSN的患者进行回顾性病历审查。在此期间，33例患者接受了HALSN，并与33例接受根治性手辅助腹腔镜肾切除术（HALRN）的患者进行匹配。
两组手术时间相似（HALSN组为301分钟，HALRN组为286分钟；P = 0.54）。两组均无术中或术后输血情况。HALSN组有1例患有黄色肉芽肿性肾盂肾炎的患者转为开放肾切除术，HALRN组无转为开放手术的情况。两组平均阿片类药物等效需求量无统计学差异（HALSN组为110，HALRN组为120，P = 0.70）。接受HALSN和HALRN的患者平均住院时间相似（分别为5.0±3.8天和4.0±1.2天，P = 0.63）。HALSN组有1例严重并发症（肺栓塞），HALRN组无严重并发症。两组轻微并发症发生率相当（HALSN组为18%，HALRN组为24%）。
与HALRN相比，HALSN的手术时间和术后住院时间可能相似，并发症发生率也相当。
