Liu Xiaolong S, Narins Hadley W, Maley Warren R, Frank Adam M, Lallas Costas D
Department of Urology, Thomas Jefferson University, Philadelphia, PA, USA.
JSLS. 2012 Apr-Jun;16(2):202-7. doi: 10.4293/108680812x13427982376068.
To examine donor and recipient outcomes after right-sided robotic-assisted laparoscopic donor nephrectomy (RALDN) compared with standard laparoscopic donor nephrectomy (LDN) and to determine whether robotic-assistance enhances LDN.
MATERIALS & METHODS: From December 2005 to January 2011, 25 patients underwent right-sided LDN or RALDN. An IRB-approved retrospective review was performed of both donor and recipient medical charts. Primary endpoints included both intraoperative and postoperative outcomes.
Twenty right-sided LDNs and 5 RALDNs were performed during the study period. Neither estimated blood loss (76.4 mL vs. 30 mL, P = .07) nor operative time (231 min vs. 218 min, P = .61) were significantly different between either group (LDN vs. RALDN). Warm ischemia time for LDN was 2.6 min vs. 3.8 min for RALDN (P = .44). Donor postoperative serum estimated glomerular filtration rates (eGFR) were similar (53 vs. 59.6 mL/min/1.73 m2, LDN vs. RALDN, P = .26). For the recipient patients, posttransplant eGFR were similar at 6 months (53.4 vs. 59.8 mL/min/1.73 m2, LDN vs. RALDN, P = .53).
In this study, robotic-assistance did not improve outcomes associated with LDN. Larger prospective studies are needed to confirm any perceived benefit of RALDN.
比较右侧机器人辅助腹腔镜供肾切除术（RALDN）与标准腹腔镜供肾切除术（LDN）后供体和受体的结局，并确定机器人辅助是否能改善LDN。
2005年12月至2011年1月，25例患者接受了右侧LDN或RALDN。对供体和受体的病历进行了经机构审查委员会批准的回顾性研究。主要终点包括术中及术后结局。
研究期间共进行了20例右侧LDN和5例RALDN。两组之间的估计失血量（76.4 mL对30 mL，P = 0.07）和手术时间（231分钟对218分钟，P = 0.61）均无显著差异（LDN对RALDN）。LDN的热缺血时间为2.6分钟，而RALDN为3.8分钟（P = 0.44）。供体术后血清估计肾小球滤过率（eGFR）相似（53对59.6 mL/min/1.73 m2，LDN对RALDN，P = 0.26）。对于受体患者，移植后6个月的eGFR相似（53.4对59.8 mL/min/1.73 m2，LDN对RALDN，P = 0.53）。
在本研究中，机器人辅助并未改善与LDN相关的结局。需要更大规模的前瞻性研究来证实RALDN的任何潜在益处。
