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纯腹腔镜与开放活体供肾肾切除术后供体的长期结局:关注妊娠率、高血压及生活质量

Long-Term Donor Outcomes after Pure Laparoscopic versus Open Living Donor Nephrectomy: Focus on Pregnancy Rates, Hypertension and Quality of Life.

作者信息

Friedersdorff Frank, Kothmann Lisa, Manus Philipp, Roigas Jan, Kempkensteffen Carsten, Magheli Ahmed, Busch Jonas, Liefeldt Lutz, Giessing Markus, Deger Serdar, Schostak Martin, Miller Kurt, Fuller Tom Florian

机构信息

Department of Urology, Charité University Hospital, Berlin, Germany.

出版信息

Urol Int. 2016;97(4):450-456. doi: 10.1159/000447064. Epub 2016 Aug 30.

Abstract

INTRODUCTION

The aim of the present study was to compare long-term donor outcomes after open and laparoscopic living donor nephrectomy. The focus was on pregnancy rates, hypertension and quality of life parameters.

MATERIALS AND METHODS

Data were retrospectively collected using our institution's electronic database and a structured questionnaire. The study included 30 donors after open donor nephrectomy (ODN) and 131 donors after laparoscopic donor nephrectomy (LDN).

RESULTS

Demographic data did not differ between groups. When asked for their preference, significantly more donors in the LDN group would choose the same surgical approach again. The overall frequency of postoperative complications was significantly lower in the LDN group. The incidence of grade III complications was 2% after LDN and 10% after ODN (p = 0.79). Only 2 out of 15 female donors aged between 18 and 45 years delivered a healthy child after DN. On interview, only 4 out of 15 female donors declared the desire to have children after DN.

CONCLUSIONS

From the donor perspective, long-term outcomes after LDN are more favorable than after ODN. To ensure favorable functional outcomes, strict preoperative donor selection and diligent long-term donor follow-up are required.

摘要

引言

本研究的目的是比较开放性和腹腔镜活体供肾切除术后供体的长期结局。重点关注妊娠率、高血压和生活质量参数。

材料与方法

使用我们机构的电子数据库和结构化问卷回顾性收集数据。该研究包括30例开放性供肾切除术(ODN)后的供体和131例腹腔镜供肾切除术(LDN)后的供体。

结果

两组之间的人口统计学数据无差异。当被问及他们的偏好时,LDN组中明显更多的供体愿意再次选择相同的手术方式。LDN组术后并发症的总体发生率显著更低。LDN术后III级并发症的发生率为2%,ODN术后为10%(p = 0.79)。15名年龄在18至45岁之间的女性供体中,只有2人在供肾切除术后生下了健康的孩子。在访谈中,15名女性供体中只有4人表示希望在供肾切除术后生育。

结论

从供体角度来看,LDN后的长期结局比ODN更有利。为确保良好的功能结局,需要严格的术前供体选择和认真的长期供体随访。

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