摘要
目的探究手助腹腔镜下活体供肾切取手术时间的影响因素,并探究其与术后并发症严重程度间的关系。方法回顾性分析91例行手助腹腔镜下活体供肾切取术的供者的临床资料,分析供者术前基线资料与手术时间之间的相关性,研究手术时间与术后并发症的关系并确定手术时间的阈值。结果肾动脉数量多、肾周脂肪及肾脏后侧脂肪较厚、罹患代谢综合征、梅奥粘连概率(MAP)评分及Clavien-Dindo评分较高均会导致手术时间延长。通过分析受试者工作特征(ROC)曲线发现,当手术时间≥138 min时,供者术后并发症的发生率显著升高(P<0.05)。结论对于具有多支肾动脉、肾周及肾脏后侧脂肪厚度较厚、罹患代谢综合征、MAP评分及Clavien-Dindo评分较高的供者,可选择手术经验更为丰富的医师,做好充分的术前准备并在术后予以密切关注,以及时发现术后并发症并降低并发症的严重程度,改善供者预后。
Objective To identify the influencing factors of operation time of hand-assisted laparoscopic living donor nephrectomy,and to analyze the relationship between influencing factors and the severity of postoperative complications.Methods Clinical data of 91 donors who underwent hand-assisted laparoscopic nephrectomy were retrospectively analyzed.The correlation between preoperative baseline data of donors and operation time was analyzed.The relationship between operation time and postoperative complications was assessed and the threshold of operation time was determined.Results Multiple donor renal arteries,thick perirenal and posterior renal fat,metabolic syndrome,high Mayo adhesive probability(MAP)score and Clavien-Dindo score prolonged the operation time.By analyzing the receiver operating characteristic(ROC)curve,we found that when the operation time was≥138 min,the incidence of postoperative complications of donors was significantly increased(P<0.05).Conclusions For donors with multiple renal arteries,thick perirenal and posterior renal fat,metabolic syndrome and high MAP score and Clavien-Dindo score,experienced surgeons should be selected to make adequate preoperative preparation and pay close attention after surgery,so as to timely detect postoperative complications and reduce the severity of complications,enhance clinical prognosis of the donors.
作者
宋泓辰
吕竟成
郭宇文
张健
王志鹏
朱一辰
Song Hongchen;Lyu Jingcheng;Guo Yuwen;Zhang Jian;Wang Zhipeng;Zhu Yichen(Department of Urology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)
出处
《器官移植》
CAS
CSCD
北大核心
2024年第2期244-250,共7页
Organ Transplantation
基金
北京市医管中心培育计划(PX2023002)。
