Iemsupakkul Paiboon, Kongchareonsombat Wisoot, Kijvikai Kittinut
Division of Urology, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
Exp Clin Transplant. 2017 Apr;15(2):138-142. doi: 10.6002/ect.2017.0017.
Our objective was to compare the outcomes of the different extraction sites between extended iliac port site incision and Pfannenstiel incision during laparoscopic donor nephrectomy.
We prospectively evaluated patients who underwent laparoscopic donor nephrectomy from June 2014 to March 2015 at our institution. Perioperative parameters were included, with particular reference to warm ischemic time. The other parameters recorded included operative time, blood loss, hospital stay, analgesic requirement, and cosmetic results.
We analyzed a total of 41 patients. Kidney retrieval site of each patient was made randomly. Extraction sites were done by using extended iliac port site incisions in 23 patients and by Pfannenstiel incision in 18 patients. Mean warm ischemic time was 4.09 minutes with extended iliac port site incision versus 4.94 minutes with Pfannenstiel incision (P = .04). Mean operative time, blood loss, hospital stay, and analgesic requirements were comparable between the 2 groups. Mean cosmetic score was 10.39 with extended iliac port site versus 12.06 with Pfannenstiel incision.
Extraction with extended iliac port site incision had significantly less warm ischemic time than Pfannenstiel incision in laparoscopic donor nephrectomy. It was also not inferior to Pfannenstiel incision regarding the other.
我们的目的是比较腹腔镜供肾切除术期间，扩大髂部切口与耻骨上横切口在不同取肾部位的手术结果。
我们前瞻性评估了2014年6月至2015年3月在我院接受腹腔镜供肾切除术的患者。纳入围手术期参数，特别关注热缺血时间。记录的其他参数包括手术时间、失血量、住院时间、镇痛需求和美容效果。
我们共分析了41例患者。每位患者的肾脏取出部位均随机确定。23例患者采用扩大髂部切口取肾，18例患者采用耻骨上横切口取肾。扩大髂部切口组的平均热缺血时间为4.09分钟，耻骨上横切口组为4.94分钟（P = 0.04）。两组间的平均手术时间、失血量、住院时间和镇痛需求相当。扩大髂部切口组的平均美容评分为10.39分，耻骨上横切口组为12.06分。
在腹腔镜供肾切除术中，采用扩大髂部切口取肾的热缺血时间明显短于耻骨上横切口取肾。在其他方面，它也不逊色于耻骨上横切口取肾。
