Demirbas T, Bulutcu F, Dayangac M, Yaprak O, Guler N, Oklu L, Akyildiz M, Altaca G, Tokat Y, Yuzer Y
Department of Organ Transplantation, Florence Nightingale Hospital, Istanbul, Turkey.
Transplant Proc. 2013 Jan-Feb;45(1):218-21. doi: 10.1016/j.transproceed.2012.06.081.
Incision-related morbidity for donors is a major concern in living-donor right hepatectomy (LDRH). Open approaches use midline, J-shaped, and Mercedes incisions for LDRH. We retrospectively studied 95 consecutive donors who underwent LDRH between January 2009 and November 2010. They underwent midline (n = 32), J-shaped (n = 28), or Mercedes (n = 35) incisions. We studied resection times, perioperative bleeding, postoperative hospital stay, and postoperative pain assessed by the visual analog scale (VAS) and by analgesic requirements as well as laboratory data and complications. Postoperative analgesic requirements and postoperative VAS scores were significantly lower in the midline group (P < .05) upon univariate but not multivariate analyses. The postoperative complications as well as other parameters were similar between the groups. In conclusion, compared with a J-type shaped or not for Mercedes incision, a donor hepatectomy can be satisfactorily performed via a midline incision by experienced surgeons without increased risk.
供体的切口相关并发症是活体供体右半肝切除术（LDRH）中的一个主要问题。开放手术方法在LDRH中采用正中切口、J形切口和梅赛德斯切口。我们回顾性研究了2009年1月至2010年11月期间连续接受LDRH的95例供体。他们接受了正中切口（n = 32）、J形切口（n = 28）或梅赛德斯切口（n = 35）。我们研究了切除时间、围手术期出血、术后住院时间、通过视觉模拟量表（VAS）评估的术后疼痛以及镇痛需求，还有实验室数据和并发症。单因素分析时，正中切口组术后镇痛需求和术后VAS评分显著更低（P <.05），但多因素分析时并非如此。各组之间术后并发症以及其他参数相似。总之，与J形或梅赛德斯切口相比，经验丰富的外科医生通过正中切口可以令人满意地进行供体肝切除术，且不会增加风险。
