Comparison of Clinical Outcomes of Hand-Assisted Retroperitoneoscopic with the Hand-Assisted Laparoscopic Donor Nephrectomy in Healthy Kidney Donors.

IF 0.7 4区医学 Q3 MEDICINE, GENERAL & INTERNAL

Jcpsp-Journal of the College of Physicians and Surgeons Pakistan Pub Date : 2025-05-01 DOI:10.29271/jcpsp.2025.05.651

Umar Farooq, Asad Bashir, Nasrum Minallah, Fiaz Ahmad Touqeer, Zia Ul Haq Akram, Ali Asad

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引用次数: 0

Abstract

Objective: To compare the outcomes of hand-assisted laparoscopic (HALS) and hand-assisted retroperitoneoscopic (HARS) donor nephrectomy procedures.

Study design: Descriptive study. Place and Duration of the Study: Pakistan Kidney and Liver Institute and Research Centre (PKLI & RC), Lahore, Pakistan, from May 2018 to December 2022.

Methodology: Data from 358 donors were analysed for pre- and postoperative outcomes of HALS and HARS donor nephrectomies, considering techniques based on clinical judgement and donor characteristics, covering demographics, pre- and postoperative complications under multidisciplinary oversight.

Results: In a group of 358 donors, the median age was 36 years, with an interquartile range (IQR) of 29-44 years, and the median (IQR) body mass index (BMI) was 25.82 (22.57-28.53). Most donors were female (58.7%) and had blood type O (47.8%). A majority had no prior surgeries (86.0%). HALS donor nephrectomies were performed in 36.3% and HARS donor nephrectomies in 63.7%, with left kidneys predominantly procured (98.3%). The median warm ischaemia time (WIT) was 88.00 seconds (IQR: 17.25). No complications were reported in 95.5% of cases. Pain scores at 12 hours (p <0.001), 24 hours (p <0.001), 48 hours (p <0.001), and 10 days (p = 0.028), along with the length of hospital stay (LOS) (p <0.001), displayed significant differences in their distributions across procedures. HARS donor nephrectomies showed better pain management, while both techniques had similar outcomes for early bowel movement within 48 hours.

Conclusion: The study results emphasise tailored surgical approaches and meticulous postoperative care in live kidney donation surgeries. HARS technique offers advantages in postoperative pain management, contributing to optimising donor outcomes and surgical techniques.

Key words: Live kidney donation, Hand-assisted laparoscopic surgery, Hand-assisted retroperitoneal surgery, Laparoscopic donor nephrectomy, Surgical outcomes, Perioperative complications.

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健康供肾者手扶后腹腔镜与手扶后腹腔镜供肾切除术的临床效果比较

目的：比较手辅助腹腔镜（HALS）和手辅助后腹腔镜（HARS）供肾切除术的效果。研究设计：描述性研究。研究地点和时间：巴基斯坦肾脏和肝脏研究所和研究中心（PKLI & RC），巴基斯坦拉合尔，2018年5月至2022年12月。方法：在多学科监督下，考虑基于临床判断和供体特征的技术，包括人口统计学、术前和术后并发症，分析358名供体HALS和HARS供体肾切除术的术前和术后结果。结果：358例献血者年龄中位数为36岁，四分位数范围（IQR） 29 ~ 44岁，身体质量指数（BMI）中位数（IQR） 25.82（22.57 ~ 28.53）。献血者以女性（58.7%）和O型血（47.8%）居多。大多数患者（86.0%）没有手术史。HALS供体肾切除术占36.3%，HARS供体肾切除术占63.7%，以左肾为主（98.3%）。中位热缺血时间（WIT）为88.00秒（IQR: 17.25）。95.5%的病例无并发症。结论：研究结果强调在活体肾捐赠手术中有针对性的手术方法和细致的术后护理。HARS技术在术后疼痛管理方面具有优势，有助于优化供体结果和手术技术。关键词：活体肾脏捐献，手扶腹腔镜手术，手扶腹膜后手术，腹腔镜供肾切除术，手术结果，围手术期并发症

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Jcpsp-Journal of the College of Physicians and Surgeons Pakistan MEDICINE, GENERAL & INTERNAL-

CiteScore

1.40

自引率

0.00%

发文量

453

审稿时长

3-6 weeks

期刊介绍： Journal of College of Physicians and Surgeons Pakistan (JCPSP), is the prestigious, peer reviewed monthly biomedical journal of the country published regularly since 1991. Established with the primary aim of promotion and dissemination of medical research and contributed by scholars of biomedical sciences from Pakistan and abroad, it carries original research papers, , case reports, review articles, articles on medical education, commentaries, short communication, new technology, editorials and letters to the editor. It covers the core biomedical health science subjects, basic medical sciences and emerging community problems, prepared in accordance with the “Uniform requirements for submission to bio-medical journals” laid down by International Committee of Medical Journals Editors (ICMJE). All publications of JCPSP are peer reviewed by subject specialists from Pakistan and locally and abroad.