Pal B C, Modi P R, Rizvi S J, Chauhan R, Kumar S, Nagarajan R, Kaushal D, Kute V B, Trivedi H L
Department of Urology and Transplantation Surgery, Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences, Civil Hospital Campus, Ahmedabad - 380016, Gujarat, India.
Department of Nephrology and Transplantation Medicine, Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences, Civil Hospital Campus, Ahmedabad - 380016. Gujarat, India.
Int J Organ Transplant Med. 2017;8(4):180-185. Epub 2017 Nov 1.
Retroperitoneoscopic donor nephrectomy (RDN) is a well-established modality for the procurement of kidneys for renal transplantation. However the learning curve of pure RDN is not yet defined. Defining the learning curve will help in proper mentorship of the new donor surgeons besides providing safety to the donors.
To define the learning curve of pure RDN.
We analyzed the prospectively collected data of 102 voluntary kidney donors who underwent RDN by a single surgeon between August 2012 and April 2015 at our center. The donors were classified into group A (1-34), group B (35-68), and group C (69-102) according to the chronological order of their surgery. Left RDN was performed in 28 (82%), 25 (74%), and 28 (82%) donors of group A, B, and C, respectively. Right RDN was performed in 6 (18%), 9 (26%), and 6 (18%) donors of group A, B, and C, respectively. The clinical data were analyzed for each group.
Statistically significant difference was observed for the mean operative time (p<0.01) and warm ischemia time (p<0.04). The operative time remained around 200 minutes after the initial 35 cases.
The learning curve of pure RDN was 35 cases, although the mastery requires more number of cases to be performed.
后腹腔镜供肾切除术（RDN）是一种成熟的获取肾脏用于肾移植的方式。然而，单纯RDN的学习曲线尚未明确。明确学习曲线不仅有助于对新的供体外科医生进行恰当的指导，还能为供体提供安全保障。
明确单纯RDN的学习曲线。
我们分析了2012年8月至2015年4月期间在我们中心由一位外科医生为102名自愿捐献肾脏者进行RDN手术所前瞻性收集的数据。根据手术的时间顺序，将捐献者分为A组（1 - 34例）、B组（35 - 68例）和C组（69 - 102例）。A组、B组和C组分别有28例（82%）、25例（74%）和28例（82%）的捐献者接受了左肾RDN手术。A组、B组和C组分别有6例（18%）、9例（26%）和6例（18%）的捐献者接受了右肾RDN手术。对每组的临床数据进行分析。
观察到平均手术时间（p<0.01）和热缺血时间（p<0.04）存在统计学显著差异。最初35例手术后，手术时间维持在200分钟左右。
单纯RDN的学习曲线为35例，尽管要达到熟练掌握还需要进行更多例数的手术。
