Department of Surgery, Jeonbuk National University Medical School, Jeonju, Korea. Electronic address: https://twitter.com/hirojawa.
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Surgery. 2021 Jul;170(1):271-276. doi: 10.1016/j.surg.2021.03.002. Epub 2021 Apr 10.
This study evaluated the safety and effectiveness of minimally invasive living donor hepatectomy in comparison with the open procedure, using Korean Organ Transplantation Registry data.
We reviewed the prospectively collected data of all 1,694 living liver donors (1,071 men, 623 women) who underwent donor hepatectomy between April 2014 and December 2017. The donors were grouped on the basis of procedure type to the minimally invasive procedure group (n = 304) or to the open procedure group (n = 1,390) and analyzed the relationships between clinical data and complications.
No donors died after the procedure. The overall complication rates after operation in the minimally invasive procedure group and the open procedure group were 6.2% and 3.5%, respectively. Biliary complications were the most frequent events in both groups (minimally invasive procedure group, 2.4%; open procedure group, 1.6%). The majority of complications occurred within 7 days after surgery in both groups. The duration of hospitalization was shorter in the minimally invasive procedure group than in the open procedure group (9.04 ± 3.78 days versus 10.29 ± 4.01 days; P < .05).
Based on its similar outcomes in our study, minimally invasive donor hepatectomy cannot be an alternative option compared with the open procedure method. To overcome this, we need to ensure better surgical safety, such as lower complication rate and shorter duration of hospitalization.
本研究使用韩国器官移植登记处的数据，评估了微创活体供肝切除术与开放手术相比的安全性和有效性。
我们回顾了 2014 年 4 月至 2017 年 12 月期间所有 1694 名接受供肝切除术的活体供者（1071 名男性，623 名女性）的前瞻性收集数据。根据手术类型将供者分为微创组（n=304）或开放组（n=1390），分析临床数据与并发症之间的关系。
术后无供者死亡。微创组和开放组术后总并发症发生率分别为 6.2%和 3.5%。两组中最常见的并发症均为胆道并发症（微创组 2.4%，开放组 1.6%）。两组大多数并发症均发生在术后 7 天内。微创组的住院时间短于开放组（9.04±3.78 天比 10.29±4.01 天；P<0.05）。
根据本研究的结果，微创活体供肝切除术与开放手术相比并不能作为一种替代方法。为了克服这一问题，我们需要确保更好的手术安全性，如降低并发症发生率和缩短住院时间。
