Yu Shengqiang, Men Changping, Liu Lingling, Li Guanglei, Liu Dongfu, Gao Zhenli, Wang Ke
Urology Department, Yantai Yuhuangding Hospital, Medical College of Qingdao University, Yantai, China.
ANZ J Surg. 2014 Sep;84(9):649-52. doi: 10.1111/ans.12561. Epub 2014 Mar 25.
Retroperitoneoscopic live donor nephrectomy has been performed in many countries. The purpose of this study was to evaluate the inguinal incision as a route for hand-assisted manipulation and allograft retrieval.
From April 2011 to June 2012, a prospective clinical study of 21 cases of retroperitoneal live donor nephrectomy was performed at our hospital. All donors were grouped in a test group (n = 11, inguinal incision) or a control group (n = 10, lumbar incision). The operative time, warm ischaemia time, blood loss, hospital stay, cosmetic satisfaction, incision complications, and recipient's serum creatinines were compared between groups.
All 21 cases of retroperitoneal live donor nephrectomy were accomplished successfully without serious complications. There was no difference in blood loss and operative time between groups. The mean warm ischaemic time and hospital stay was shorter (P < 0.01), and satisfaction with cosmesis was greater (P < 0.05) in the test group. The abdominal asymmetry (4/10) and wound dehiscence occurred only in the control group. The recipient's serum creatinine was lower in the test group at 1 day (P < 0.01) and 3 days (P < 0.05) after transplantation.
The inguinal incision offers an ideal route for hand-assisted manipulation and allograft retrieval during retroperitoneoscopic live donor nephrectomy, and has a potential to be generally applied in the future.
后腹腔镜活体供肾切除术已在许多国家开展。本研究旨在评估腹股沟切口作为手辅助操作及移植肾取出途径的效果。
2011年4月至2012年6月,我院对21例后腹腔镜活体供肾切除术进行了前瞻性临床研究。所有供者分为试验组(n = 11,采用腹股沟切口)和对照组(n = 10,采用腰部切口)。比较两组的手术时间、热缺血时间、失血量、住院时间、美容满意度、切口并发症及受者血清肌酐水平。
21例后腹腔镜活体供肾切除术均成功完成,无严重并发症。两组间失血量和手术时间无差异。试验组平均热缺血时间和住院时间较短(P < 0.01),美容满意度更高(P < 0.05)。腹部不对称(4/10)及伤口裂开仅发生在对照组。移植后1天(P < 0.01)和3天(P < 0.05)试验组受者血清肌酐水平较低。
腹股沟切口为后腹腔镜活体供肾切除术中手辅助操作及移植肾取出提供了理想途径,未来有可能得到广泛应用。