Lecoanet Pierre, Chammas Mario F, Sime Willy Ngueyon, Guillemin Francis, Karam Georges, Ladrière Marc, Eschwège Pascal, Mitre Anuar I, Frimat Luc, Hubert Jacques
Department of Urology, University Hospital, Nancy, France.
Division of Urology, University of São Paulo, São Paulo, Brazil.
Transplant Proc. 2022 Apr;54(3):696-701. doi: 10.1016/j.transproceed.2022.02.005. Epub 2022 Mar 17.
We evaluated different techniques of donor nephrectomy.
Outcomes of 4 surgical approaches (open surgery [OS], standard laparoscopy [SL], hand-assisted laparoscopy [HAL], and robot-assisted la`paroscopy [RAL]) were compared.
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.
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.
我们评估了供体肾切除术的不同技术。
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。
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。
4种不同的肾切除术手术方式有相似的良好结果。机器人辅助技术是一种替代选择，并发症发生率低，疼痛较轻，结果与其他技术相当。
