非肌肉分裂小切口供肾切除术在腹腔镜活体肾捐献时代仍然是一种可行的技术

Q4 Medicine
Lex J. M. Habets, A. Baranski, K. Ramdhani, D. van der Helm, Ada Haasnoot, A. D. de Vries, K. V. D. van der Bogt, A. Braat, J. Dubbeld, H. Lam, J. Nieuwenhuizen, W. Nijboer, D. D. de Vries, I. Alwayn, A. Schaapherder, V. Huurman
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引用次数: 0

摘要

腹腔镜供肾切除术(LDN)是目前肾捐赠的金标准。小切口开放供肾切除术(MINI)技术已被广泛应用,但已不太流行。本研究的目的是比较非肌肉分裂MINI技术与当前LDN金标准的结果和安全性。该研究采用了2011年至2019年期间所有活体供体肾脏切除术的单中心回顾性队列研究。该研究的主要结局是短期(<30天),伴有Clavien-Dindo级并发症。次要结果包括围手术期数据的多变量回归分析。MINI和LDN的并发症发生率无差异,校正已知混杂因素后也无差异。正如预期的那样,MINI组的手术时间和首次热缺血明显缩短,LDN组的出血量较少。LDN患者的并发症和转换率(LDN到open)与最近发表的荟萃分析一致。本研究在现代实践中证实了活体肾脏捐献的围手术期安全性。MINI和LDN手术的并发症发生率是有限的,不同手术之间没有差异。在特定情况下,MINI程序仍然可以被认为是一种安全可行的活体肾脏捐赠选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Non-Muscle-Splitting Mini-Incision Donor Nephrectomy Remains a Feasible Technique in the Laparoscopic Era of Living Kidney Donation
Laparoscopic donor nephrectomy (LDN) is the current gold standard in kidney donation. Mini-incision open donor nephrectomy (MINI) techniques have been used extensively but have become less popular. The aim of the present study was to compare the results and safety of a non-muscle-splitting MINI technique with the current gold standard of LDN. A single center retrospective cohort study of all living donor nephrectomies between 2011 and 2019 was used for the study. The primary outcome of this study was short term (<30 days) with Clavien–Dindo grade complications. Secondary outcomes included multivariable regression analysis of perioperative data. No differences in complication rates were observed between MINI and LDN and also after correction for known confounders. As expected, the operative time and first warm ischemia were significantly shorter in the MINI group and less blood loss was observed in the LDN group. Complications and conversion rate (LDN to open) among the LDN patients were in line with recent published meta-analyses. This study confirms the perioperative safety of living kidney donation in modern practice. Complication rates of both MINI and LDN procedures are limited and not different between procedures. In specific circumstances, the MINI procedure can still be considered a safe and feasible alternative for living kidney donation.
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来源期刊
Cell and Organ Transplantology
Cell and Organ Transplantology Medicine-Transplantation
CiteScore
0.40
自引率
0.00%
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8
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