Department of Urology, Suleyman Demirel University School of Medicine, Isparta, Turkey,
Department of General Surgery and Transplantation, Medical Park Hospital, Antalya, Turkey.
Urol Int. 2021;105(1-2):100-107. doi: 10.1159/000511377. Epub 2020 Nov 18.
Donors' health and safety are mandatory in the living-donor kidney transplantation procedure. Laparoscopic live donor nephrectomy (LLDN) provides an increase in donor numbers with its benefits and becomes a standard of care. We aimed to explain the results, complication rates, tips, and tricks of the largest number of LLDN case series ever performed in the literature.
Between August 2012 and December 2019, 2,477 live donor case files were analyzed retrospectively. Age, gender, hospitalization times, body mass index, warm ischemia times, operation times, numbers of arteries, side of the kidneys, and complications were noted.
1,421 (57.4%) of 2,477 donors were female (p = 0.007). Operation times and warm ischemia times were found longer in right-sided LLDN and donors with multiple renal arteries (p = 0.046, <0.001, and <0.001, respectively). Obesity (BMI >30 kg/m2) did not affect warm ischemia times while prolonging the operation times (p = 0.013). Hospitalization times and numbers of complications were higher in obese donors.
LLDN seems to be a reliable solution with fewer complications and higher satisfaction rates. We hope to illuminate the way with tips and trick points for beginner transplant surgeons based on the experience obtained from 2,477 LLDN cases.
在活体供肾移植过程中，供者的健康和安全是强制性的。腹腔镜下活体供肾切除术（LLDN）具有增加供者数量的优势，并成为一种常规治疗方法。我们旨在解释文献中报告的最大数量的 LLDN 病例系列的结果、并发症发生率、技巧和窍门。
回顾性分析 2012 年 8 月至 2019 年 12 月期间的 2477 例活体供体病例档案。记录年龄、性别、住院时间、体重指数、热缺血时间、手术时间、动脉数量、肾脏侧别和并发症。
2477 名供者中，1421 名（57.4%）为女性（p=0.007）。右侧 LLDN 和有多发肾动脉的供者的手术时间和热缺血时间较长（p=0.046，<0.001 和<0.001）。肥胖（BMI>30kg/m2）虽然延长了手术时间，但并不影响热缺血时间（p=0.013）。肥胖供者的住院时间和并发症数量较高。
LLDN 似乎是一种可靠的解决方案，具有较少的并发症和更高的满意度。我们希望根据 2477 例 LLDN 病例获得的经验，为初学者移植外科医生提供技巧和窍门，指明方向。
