Department of Radiology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands.
Department of Internal Medicine, Division of Nephrology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands.
Br J Surg. 2019 May;106(6):711-719. doi: 10.1002/bjs.11127. Epub 2019 Mar 27.
Data on chronic pain after kidney donation are sparse. The aim of this study was to assess the incidence of chronic pain after hand-assisted laparoscopic nephrectomy.
Living kidney donors who donated between 2011 and 2017 at the University Medical Centre Groningen were included. All patients underwent hand-assisted laparoscopic donor nephrectomy. Postdonation pain and movement disabilities were assessed using the Carolinas Comfort Scale (CCS) and a visual analogue scale (VAS). The prevalence, severity of pain and the need for analgesics were reported.
Some 333 living kidney donors with a mean age of 56 years were included. At a median of 19 (i.q.r. 10-33) months after donation, 82 donors (24·6 per cent) had a CCS score above 0, of which 58 (71 per cent) had a CCS score of at least 2 and 57 (70 per cent) reported movement limitations. Some 110 donors (33·0 per cent) had a VAS score of more than 0. Complaints mainly occurred during bending over (12·3 per cent) and exercising (12·4 per cent). Thirty-two donors (9·7 per cent) required analgesics during follow-up between donation and the time of measurement, and six of 82 (7 per cent) reported chronic inguinal pain. In multivariable analysis, donor age (odds ratio (OR) 0·97, 95 per cent c.i. 0·95 to 0·99; P = 0·020) and length of hospital stay (OR 1·21, 1·01 to 1·51; P = 0·041) were independently associated with chronic pain.
One-quarter of donors experienced chronic postdonation pain or discomfort, most of which was bothersome. Younger donors and those with a longer postoperative hospital stay had more symptoms.
有关肾捐献后慢性疼痛的数据很少。本研究旨在评估手助腹腔镜肾切除术术后慢性疼痛的发生率。
纳入 2011 年至 2017 年在格罗宁根大学医学中心进行活体肾捐献的患者。所有患者均接受手助腹腔镜供肾切除术。术后通过卡罗莱纳舒适度量表（CCS）和视觉模拟评分（VAS）评估疼痛和活动受限情况。报告疼痛的发生率、严重程度和对止痛药的需求。
共纳入 333 名平均年龄为 56 岁的活体肾捐献者。在捐赠后中位数为 19 个月（IQR 10-33）时，82 名（24.6%）供者的 CCS 评分>0，其中 58 名（71%）CCS 评分≥2，57 名（70%）报告活动受限。110 名（33.0%）供者的 VAS 评分>0。主要在弯腰（12.3%）和运动（12.4%）时出现不适。32 名（9.7%）供者在捐赠后至测量期间需要止痛药，82 名中有 6 名（7%）报告慢性腹股沟疼痛。多变量分析显示，供者年龄（比值比（OR）0.97，95%可信区间 0.95-0.99；P=0.020）和住院时间（OR 1.21，1.01-1.51；P=0.041）与慢性疼痛独立相关。
四分之一的供者经历了慢性术后疼痛或不适，其中大部分令人烦恼。年轻的供者和术后住院时间较长的供者症状更多。
