Cho Hyuk Jin, Choi Sae Woong, Kim Kang Sup, Park Yong Hyun, Bae Woong Jin, Hong Sung-Hoo, Lee Ji Youl, Kim Sae Woong, Hwang Tae-Kon
Department of Urology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine , Seoul, Korea.
J Laparoendosc Adv Surg Tech A. 2015 Aug;25(8):636-41. doi: 10.1089/lap.2014.0570. Epub 2015 Jun 1.
To present our experience with laparoendoscopic single-site plus one-port donor nephrectomy (LESSOP-DN) and compare the outcomes with laparoscopic donor nephrectomy (LDN).
Prospectively collected data from 169 consecutive LESSOP-DNs and 83 LDNs performed by a single surgeon in the same time period were analyzed retrospectively.
No differences in mean operative time (136 versus 130 minutes; P=.15), warm ischemia time (3.4 versus 3.5 minutes; P=.42), blood loss (50 versus 45 mL; P=.41), transfusion rates (0 versus 1 case), hospital stay (4.0 versus 3.9 days; P=.48), or overall complication rate (12.0% versus 7.7%; P=.25) were observed between the LDN and LESSOP-DN groups. The LESSOP-DN group had a shorter time to return to 100% recovery (39 versus 74 days; P<.001), a smaller surgical incision (5.5 versus 8.2 cm; P<.001), higher scar satisfaction score (8.1 versus 6.4; P=.003), and lower analgesic requirements (79.0 versus 68.5 mg; P=.03) than the LDN group. Renal function of the recipient based on estimated glomerular filtration rate at 1 and 3 months was similar between the groups. Health-related quality of life (QOL) was significantly higher in the LESSOP-DN group in four domains of the health survey than in the LDN group.
LESSOP-DN might be associated with smaller surgical incision, improved cosmetic satisfaction, less time to recovery, less analgesic requirement, improved donor QOL, and equivalent recipient graft function.
介绍我们开展腹腔镜单孔加单端口供体肾切除术（LESSOP-DN）的经验，并将其结果与腹腔镜供体肾切除术（LDN）进行比较。
回顾性分析同一时期由一名外科医生连续实施的169例LESSOP-DN和83例LDN的前瞻性收集数据。
LDN组和LESSOP-DN组在平均手术时间（136分钟对130分钟；P = 0.15）、热缺血时间（3.4分钟对3.5分钟；P = 0.42）、失血量（50毫升对45毫升；P = 0.41）、输血率（0例对1例）、住院时间（4.0天对3.9天；P = 0.48）或总体并发症发生率（12.0%对7.7%；P = 0.25）方面均未观察到差异。LESSOP-DN组恢复至100%康复的时间更短（39天对74天；P < 0.001），手术切口更小（5.5厘米对8.2厘米；P < 0.001），瘢痕满意度评分更高（8.1对6.4；P = 0.003），镇痛需求更低（79.0毫克对68.5毫克；P = 0.03）。两组间受体基于1个月和3个月时估计肾小球滤过率的肾功能相似。在健康调查的四个领域中，LESSOP-DN组的健康相关生活质量（QOL）显著高于LDN组。
LESSOP-DN可能与更小的手术切口、更高的美容满意度、更短的恢复时间、更低的镇痛需求、改善供体QOL以及同等的受体移植物功能相关。
