Hand-assisted laparoscopic living-donor nephrectomy as an alternative to traditional laparoscopic living-donor nephrectomy

被引:48
作者
Buell, JF [1 ]
Hanaway, MJ [1 ]
Potter, SR [1 ]
Cronin, DC [1 ]
Yoshida, A [1 ]
Munda, R [1 ]
Alexander, JW [1 ]
Newell, KA [1 ]
Bruce, DS [1 ]
Woodle, ES [1 ]
机构
[1] Univ Cincinnati, Div Transplantat, Cincinnati, OH 45267 USA
关键词
financial impact; hand-assisted laparoscopy; kidney allograft; laparoscopic donor nephrectomy;
D O I
10.1034/j.1600-6143.2002.21017.x
中图分类号
R61 [外科手术学];
学科分类号
摘要
The benefits of laparoscopic living-donor nephrectomy (LDN) are well described, while similar data on hand-assisted laparoscopic living-donor nephrectomy (HALDN) are lacking. We compare hand-assisted laparoscopic living-donor nephrectomy with open donor nephrectomy. One hundred consecutive hand-assisted laparoscopic living-donor nephrectomy (10/988/01) donor/recipient pairs were compared to 50 open donor nephrectomy pairs (8/97- 1/00). Mean donor weights were similar (179.6 +/- 40.8 vs. 167.4 +/- 30.3 lb; p = NS), while donor age was greater among hand-assisted laparoscopic living-donor nephrectomy (38.2 +/- 9.5 vs. 31.2 +/- 7.8 year; p < 0.01). Right nephrectomies was fewer in hand-assisted laparoscopic living-donor nephrectomy [17/100 (17%) vs. 22/50 (44%); p < 0.05]. Operative time for hand-assisted laparoscopic living-donor nephrectomy (3.9 +/- 0.7 vs. 2.9 +/- 0.5 h; p < 0.01) was longer; however, return to diet (6.9 +/- 2.8 vs. 25.6 +/- 6.1 h; p < 0.01), narcotics requirement (17.9 +/- 6.3 vs. 56.3 +/- 6.4 h; p < 0.01) and length of stay (51.7 +/- 22.2 vs. 129.6 +/- 65.7 h; p < 0.01) were less than open donor nephrectomy. Costs were. similar ($11072 vs. 10840). Graft function and 1-week Cr of 1.4 +/- 0.9 vs. 1.6 +/- 1.1 g/dL (p = NS) were similar. With the introduction of HALDN, our laparoscopic living-donor nephrectomy program has increased by 20%. Thus, similar to traditional laparoscopic donor nephrectomy, hand-assisted laparoscopic living-donor nephrectomy provides advantages over open donor nephrectomy without increasing costs.
引用
收藏
页码:983 / 988
页数:6
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