3D腹腔镜与开放手术活体供肾切取术的临床疗效对比

Comparison of clinical efficacy between 3D laparoscopic and open surgery for living donor nephrectomy

目的探讨3D腹腔镜和开放手术活体供肾切取术的临床疗效。方法选取2011年1月至2019年2月期间于我移植中心完成的35例活体供肾切取术病例,根据手术方式不同,分别将行3D腹腔镜活体供肾切取术和开放活体供肾切取术的患者分为3D腹腔镜组(11例)和开放组(24例),比较两组的手术时间、术中出血量、供肾热缺血时间、肾动脉长度、肾静脉长度、切口长度、术后24 h VAS、术后引流管拔除时间、术后出院时间、术前血肌酐、术后第1日血肌酐、术后第3日血肌酐、术后第7日血肌酐。结果与开放组相比,3D腹腔镜组手术时间长、术中出血量少、手术切口小、术后24 h VAS评分低、术后引流管拔除时间早和术后住院时间短(P<0.05),术前血肌酐、术后第1日血肌酐、术后第3日血肌酐及术后第7日血肌酐差异无统计学意义(P>0.05)。结论3D腹腔镜活体供肾切取术安全可行,手术效果良好,具有对供体创伤小,术后供体恢复快等优势。

Objective To investigate the clinical efficacy of 3D laparoscopic and open surgery for living donor nephrectomy.Methods A total of 35 patients with live donor kidney resection at our transplant center from January 2011 to February 2019 were enrolled.According to different surgical procedures,3D laparoscopic living donor nephrectomy and open living donor kidney were performed on different cases.The patients who underwent surgery were divided into 3D laparoscopic group(11 cases)and open group(24 cases).The operation time,intraoperative blood loss,renal warm ischemia time,renal artery length,renal vein length,and incision length,postoperative 24 h VAS,postoperative drainage tube removal time,postoperative discharge time,preoperative serum creatinine,postoperative 1 day serum creatinine,postoperative 3rd day serum creatinine,postoperative 7th day serum creatinine were compared between the two groups.Results Compared with the open group,the 3D laparoscopic group had a longer operation time,less intraoperative blood loss,smaller surgical incision,lower VAS score at 24 hours after surgery,earlier postoperative drainage tube removal time and shorter postoperative hospital stay(P<0.05).There was no significant difference in serum creatinine,serum creatinine on the first day after surgery,serum creatinine on the 3rd day after surgery,and serum creatinine on the 7th day after surgery(P>0.05).Conclusion 3D laparoscopic live donor nephrectomy is safe and feasible with good surgical results,and has the advantages of less donor trauma and faster postoperative donor recovery.