Kim Sang-Dong, Kim Ji-Il, Moon In-Sung, Park Sun-Cheol
Department of Surgery, Division of Vascular and Transplant Surgery, College of Medicine, The Catholic University of Korea, Seoul 137-040, Korea.
Chin Med J (Engl). 2016 Apr 20;129(8):917-21. doi: 10.4103/0366-6999.179800.
Recently, the most common incision for kidney transplantation (KT) is an inverted J-shaped incision known as the "hockey-stick." However, demands for minimally invasive surgery in KT are increasing as in other various fields of surgery. Hence, we evaluated whether there is difference between minimal skin incision technique in kidney transplantation (MIKT) and conventional KT (CKT) .
Between June 2006 and March 2013, a total of 452 living kidney transplant patients were enrolled. The MIKT group included 17 young unmarried women whose body mass index was <25 kg/m2 and had no anatomic variation. The CKT group included 435 patients. The MIKT operation technique restricted to the 10 cm-sized skin incision in the lower right abdomen from laterally below the anterior superior iliac spine to the midline just above the pubis was performed. We compared the baseline clinical characteristics and postoperative results between two groups. For proper comparison, propensity score matching was implemented.
There was no difference in graft function, survival, and postoperative complication rate between MIKT and CKT groups (all P > 0.05). The 5-year graft survival was 92.3% and 85.7% in MIKT and CKT groups, respectively (P = 0.786).
Our results indicated that MIKT showed more favorable cosmetic results, and there were no statistical differences in various postoperative factors including graft function, survival, and complications compared with CKT. Hence, we suggested that MIKT is an appropriate method for selected patients in living KT.
最近,肾移植(KT)最常用的切口是一种倒J形切口,即所谓的“曲棍球棒”切口。然而,与其他各种外科手术领域一样,肾移植中对微创手术的需求也在增加。因此,我们评估了肾移植最小皮肤切口技术(MIKT)与传统肾移植(CKT)之间是否存在差异。
2006年6月至2013年3月期间,共纳入452例活体肾移植患者。MIKT组包括17名年轻未婚女性,其体重指数<25kg/m²且无解剖变异。CKT组包括435例患者。实施的MIKT手术技术仅限于右下腹部从髂前上棘外侧下方至耻骨上方中线的10cm大小的皮肤切口。我们比较了两组的基线临床特征和术后结果。为了进行适当的比较,实施了倾向评分匹配。
MIKT组和CKT组在移植功能、生存率和术后并发症发生率方面无差异(所有P>0.05)。MIKT组和CKT组的5年移植生存率分别为92.3%和85.7%(P=0.786)。
我们的结果表明,MIKT的美容效果更佳,与CKT相比,在包括移植功能、生存率和并发症在内的各种术后因素方面无统计学差异。因此,我们建议MIKT是活体肾移植中适合特定患者的一种方法。