Şahin Selçuk, Özdemir Osman, Ekşi Mithat, Evren İsmail, Karadağ Serdar, Özlü Deniz Noyan, Taşçı Ali İhsan
Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Urology, Istanbul, Turkey.
Arnavutköy State Hospital, Department of Urology. Istanbul, Turkey.
Urol J. 2022 Dec 25;20(1):11-16. doi: 10.22037/uj.v19i.7233.
Laparoscopic donor nephrectomy (LDN) is the most commonly used method for kidney removal in kidney transplantation and, various incisions are used for kidney extraction. In this study, we aimed to compare the results of LDN operations using iliac fossa incision and Pfannenstiel incision.
LDN cases performed in our institute between June 2016 and February 2020 were retrospectively analyzed. Patients with previous abdominal surgery, bleeding coagulation disorders, ectopic kidneys, and patients who were converted to perioperative open surgery were excluded. Demographic data of the patients, operation times, warm ischemia times, complications were recorded and the patients were divided into two groups according to incision types.
After the inclusion and exclusion criteria, 203 patients were included in the study. Iliac fossa incision was used in 65% of the patients and the Pfannenstiel incision was used in 35% of the patients to remove the donor's kidney. There were no difference in age, body mass index, gender, and Charlson Comorbidity Index (CCI) scores between the two groups. Operation time and warm ischemia time were significantly longer in the Pfannenstiel group (p = 0.001 and p = 0.016 respectively). There was no significant difference between the two groups in terms of bleeding amount, length of hospital stay, need for narcotic analgesic, visual analog scale scores, and postoperative complications.
Both types of incisions can be used successfully and safely for the extraction of the kidney in LDN. Although WIT and operation time has been observed to be longer when a Pfannenstiel incision is made, complications and analgesic use are not different between Pfannenstiel incisions and iliac fossa incisions.
腹腔镜供肾切除术（LDN）是肾移植中最常用的取肾方法，且采用了多种切口进行肾脏摘取。在本研究中，我们旨在比较采用髂窝切口和耻骨联合上横切口的LDN手术结果。
回顾性分析2016年6月至2020年2月在我院进行的LDN病例。排除既往有腹部手术史、出血性凝血障碍、异位肾以及围手术期转为开放手术的患者。记录患者的人口统计学数据、手术时间、热缺血时间、并发症，并根据切口类型将患者分为两组。
纳入和排除标准确定后，203例患者纳入研究。65%的患者采用髂窝切口，35%的患者采用耻骨联合上横切口摘取供肾。两组患者在年龄、体重指数、性别和Charlson合并症指数（CCI）评分方面无差异。耻骨联合上横切口组的手术时间和热缺血时间明显更长（分别为p = 0.001和p = 0.016）。两组在出血量、住院时间、使用麻醉性镇痛药的需求、视觉模拟评分和术后并发症方面无显著差异。
两种类型的切口均可成功且安全地用于LDN取肾。虽然观察到采用耻骨联合上横切口时热缺血时间和手术时间更长，但耻骨联合上横切口与髂窝切口在并发症和镇痛药物使用方面并无差异
