Department of Urological Organ Transplantation, Center of Organ Transplantation, The Second Xiangya Hospital of Central South University, Changsha, P. R. China.
Clin Transplant. 2019 Jan;33(1):e13451. doi: 10.1111/ctr.13451. Epub 2019 Jan 7.
Currently, the robot-assisted laparoscopic donor nephrectomy (RDN) technique is used for live donor nephrectomy. Does it provide sufficient safety and benefits for living donors? We conducted a meta-analysis to assess the safety and efficacy of RDN compared with the laparoscopic donor nephrectomy (LDN).
Eligible studies were retrieved and screened from electronic databases from 1999 onward: PubMed, Cochrane Library, and Web of Science. Relevant parameters were explored using Review Manager V5.3 and included operative time, warm ischemia time, estimated blood loss, and length of hospital stay.
Compared with RDN, LDN had shorter operative time (min; weighted mean difference (WMD): -0.53; 95% CI: [-0.85, 0.20]; P = 0.001) and warm ischemia time (second; WMD: -55.01; 95% CI: [-71.56, 38.45]; P < 0.00001) and less estimated blood loss (mL; WMD: -28.30, 95% CI: [-46.37, 10.24], P = 0.002). The pooled analysis of postoperative pain showed lower visual analog scale (VAS) scores for RDN compared with LDN (WMD:1.28, P < 0.00001). We also observed that length of hospital stay, postoperative serum creatinine (SCr) in donors, postoperative estimated glomerular filtration rate (eGFR) of recipients and postoperative complications for donors were not significantly different between groups.
As long as RDN is practiced proficiently, it is believed that RDN is a feasible alternative to LDN.
目前，机器人辅助腹腔镜供体肾切除术（RDN）技术用于活体供体肾切除术。它为活体供者提供了足够的安全性和益处吗？我们进行了一项荟萃分析，以评估 RDN 与腹腔镜供体肾切除术（LDN）相比的安全性和有效性。
从 1999 年起，从电子数据库中检索和筛选合格的研究：PubMed、Cochrane 图书馆和 Web of Science。使用 Review Manager V5.3 探索相关参数，包括手术时间、热缺血时间、估计失血量和住院时间。
与 RDN 相比，LDN 的手术时间更短（分钟；加权均数差（WMD）：-0.53；95%CI：[-0.85，0.20]；P=0.001）和热缺血时间（秒；WMD：-55.01；95%CI：[-71.56，38.45]；P<0.00001）和估计失血量更少（毫升；WMD：-28.30，95%CI：[-46.37，10.24]，P=0.002）。术后疼痛的荟萃分析显示，RDN 的视觉模拟量表（VAS）评分低于 LDN（WMD：1.28，P<0.00001）。我们还观察到，两组间住院时间、供者术后血清肌酐（SCr）、受者术后估算肾小球滤过率（eGFR）和供者术后并发症无显著差异。
只要熟练掌握 RDN，就可以认为 RDN 是 LDN 的可行替代方法。
