Telha Khaled Abdulla, Al Kataa Mohamed Abdullah, Al-Kohlany Khaled Mohamed, Al Badany Tawfik Hassen, Alnono Ibrahim Hussen
Department of Urology, Sanaa University Medical Collage, Sanaa, Yemen.
Department of Surgery, Sanaa University Medical Collage, Sanaa, Yemen.
Turk J Urol. 2017 Dec;43(4):549-552. doi: 10.5152/tud.2017.25738. Epub 2017 Dec 1.
Renal transplantation from living related donor is the best treatment option for chronic renal failure with experience for more than 50 years. However, this procedure may expose the health and even the life of otherwise normal individuals to risk. In this prospective study we described the surgical complications of open donor nephrectomies by Clavien grading system.
Between May 2002 and December 2014, one hundred and seventy-two potentially healthy kidney donors were admitted to Althawrah General Hospital, Ibn-Sina Hospital and Military Hospital. The median age was 34 years (19-60 years) with male predominance in 64.5% of the cases. This prospective descriptive study reviews intra-, and post-operative surgical complications using Clavien grading system for surgical complications.
The procedure was done via supracostal lumbotomy incision (above 12 rib) in 112 cases (65.1%) and transcostal incision with resection of 11th rib in 60 cases (34.9%). Left kidney was taken in most of the cases (68%) while right kidney in the remaining 42% with an average warm ischemia time of 31 seconds (range, 22-34 seconds). Surgical complications by Clavien grading system were observed in 18.6% of the cases (32 cases). Grade 1 in 28 (16.4%); Grade 2 in 2 (1.2%) and Grade 3 in 2 cases (1.2%) were detected. There was no grade 4 or 5 cases in our series. Median postoperative hospital stay was 3 days (range: 2-4 days).
We found that most of the complications of open living donor nephrectomy are of grade I and higher grade complications are negligible compared to the advantages for the recipients.
亲属活体肾移植是治疗慢性肾衰竭的最佳选择,至今已有50多年的经验。然而,该手术可能会使原本健康的个体的健康甚至生命面临风险。在这项前瞻性研究中,我们采用Clavien分级系统描述了开放性供肾切除术的手术并发症。
2002年5月至2014年12月期间,172名潜在健康的肾供体入住Althawrah综合医院、伊本·西那医院和军事医院。中位年龄为34岁(19 - 60岁),64.5%的病例以男性为主。这项前瞻性描述性研究使用Clavien手术并发症分级系统回顾了术中及术后的手术并发症。
112例(65.1%)通过肋上腰部切口(第12肋以上)进行手术,60例(34.9%)通过切除第11肋的经肋切口进行手术。大多数病例(68%)取左肾,其余42%取右肾,平均热缺血时间为31秒(范围为22 - 34秒)。根据Clavien分级系统,18.6%的病例(32例)出现手术并发症。其中1级28例(16.4%);2级2例(1.2%);3级2例(1.2%)。本系列中无4级或5级病例。术后中位住院时间为3天(范围:2 - 4天)。
我们发现,开放性活体供肾切除术的大多数并发症为1级,与对受者的益处相比,更高级别的并发症可忽略不计。