微创与开放供体肾切除术：来自法国多中心经验的教训

Minimally Invasive and Open Donor Nephrectomy: Lessons Learned From a French Multicenter Experience.

作者信息

Lecoanet Pierre, Chammas Mario F, Sime Willy Ngueyon, Guillemin Francis, Karam Georges, Ladrière Marc, Eschwège Pascal, Mitre Anuar I, Frimat Luc, Hubert Jacques

机构信息

Department of Urology, University Hospital, Nancy, France.

Division of Urology, University of São Paulo, São Paulo, Brazil.

出版信息

Transplant Proc. 2022 Apr;54(3):696-701. doi: 10.1016/j.transproceed.2022.02.005. Epub 2022 Mar 17.

DOI:10.1016/j.transproceed.2022.02.005

PMID:35307168

Abstract

BACKGROUND

We evaluated different techniques of donor nephrectomy.

METHODS

Outcomes of 4 surgical approaches (open surgery [OS], standard laparoscopy [SL], hand-assisted laparoscopy [HAL], and robot-assisted la`paroscopy [RAL]) were compared.

RESULTS

A total of 264 nephrectomies were performed: 65 in the OS group, 65 in the SL group, 65 in the HAL group, and 69 in RAL group. Operative time was longer for the RAL group (P < .001) with a mean time of 202 minutes (RAL), 182 minutes (OS), 173 minutes (SL), and 157 minutes (HAL). Complications (P = .002) and consumption of morphine derivates (P = .31) were lower for the RAL group (P = .0002). The visual analog scale pain scores (P = .002), hospital stay (P = .023), and time to return to full activities (P = .79) were higher for OS.

CONCLUSIONS

The 4 different nephrectomy surgical approaches had similar favorable results. The robot-assisted technique presented as an alternative option, with low incidence of complications, less pain, and results comparable to the other techniques.

摘要

背景

我们评估了供体肾切除术的不同技术。

方法

比较了4种手术方式（开放手术[OS]、标准腹腔镜手术[SL]、手辅助腹腔镜手术[HAL]和机器人辅助腹腔镜手术[RAL]）的结果。

结果

共进行了264例肾切除术：OS组65例，SL组65例，HAL组65例，RAL组69例。RAL组的手术时间较长（P <.001），平均时间为202分钟（RAL）、182分钟（OS）、173分钟（SL）和157分钟（HAL）。RAL组的并发症（P =.002）和吗啡衍生物的消耗量（P =.31）较低（P =.0002）。OS组的视觉模拟评分疼痛评分（P =.002）、住院时间（P =.023）和恢复完全活动的时间（P =.79）较高。