Department of Urology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
Turk J Med Sci. 2020 Jun 23;50(4):922-929. doi: 10.3906/sag-1910-120.
BACGROUND/AIM: The aim of this study was to compare the complications of laparoscopic simple, radical and donor nephrectomies performed in a single center.
The study was conducted on 392 patients who underwent laparoscopic nephrectomy in University of Health Sciences, Ankara Türkiye Yüksek İhtisas Training and Research Hospital between January 1, 2008 and January 30, 2019. Clinical and laboratory parameters were recorded. Postoperative complications were recorded and graded as per Clavien-Dindo classification (CDC). All analyses were performed on SPSS v21.0 (IBM Corp., Armonk, NY, USA).
The mean age of the patients was 49.13 ± 15.45 years. The frequency of comorbidities and ASA scores were significantly higher in the laparoscopic radical nephrectomy (LRN) group than in the other groups (P < 0.001). Amount of bleeding was significantly lower in the laparoscopic donor nephrectomy (LDN) group compared to the other groups (P < 0.001). Classification of complications according to CDC showed that complications occurred in 17.01% (n = 25) of the LRN group, 7.02% (n = 12) of the laparoscopic simple nephrectomy (LSN) group, and 2.70% (n = 2) of the LDN group. Length of stay in hospital was significantly higher in the LRN group than in the LSN group (P < 0.001).
In this study, the frequency of complications in LRN procedures was found to be higher than the LSN and LDN procedures. Patients with LRN may have more adverse health conditions before the operation. Considering the results of this study, variables such as patient and hospital characteristics, surgeon experience and skills should be evaluated in future studies. In addition, it is important to determine the frequency of complications using a standardized classification in order to enable correct interpretation of results.
背景/目的：本研究旨在比较单中心施行的腹腔镜单纯性、根治性和供体肾切除术的并发症。
本研究纳入了 2008 年 1 月 1 日至 2019 年 1 月 30 日期间在土耳其安卡拉卫生科学大学高等专科培训与研究医院接受腹腔镜肾切除术的 392 例患者。记录了临床和实验室参数。根据 Clavien-Dindo 分类（CDC）记录术后并发症并进行分级。所有分析均在 SPSS v21.0（IBM 公司，纽约州阿蒙克）上进行。
患者的平均年龄为 49.13 ± 15.45 岁。腹腔镜根治性肾切除术（LRN）组的合并症和 ASA 评分频率明显高于其他组（P < 0.001）。与其他组相比，腹腔镜供体肾切除术（LDN）组的出血量明显减少（P < 0.001）。根据 CDC 对并发症进行分类显示，LRN 组并发症发生率为 17.01%（n = 25），腹腔镜单纯性肾切除术（LSN）组为 7.02%（n = 12），LDN 组为 2.70%（n = 2）。LRN 组的住院时间明显长于 LSN 组（P < 0.001）。
本研究发现，LRN 手术的并发症发生率高于 LSN 和 LDN 手术。LRN 患者在手术前可能有更多的不良健康状况。考虑到本研究的结果，在未来的研究中应评估患者和医院特征、外科医生经验和技能等变量。此外，使用标准化分类确定并发症的频率对于正确解释结果很重要。
