Abstract：
OBJECTIVE: There is a lack of concrete evidence regarding the best approach for donor nephrectomy among transplant centers. We compared donor outcomes during the period of the transition from the hand-assisted laparoscopic donor nephrectomy method to the purely laparoscopic donor nephrectomy method and have provided suggestions to minimize the initial difficulties and to improve donor outcomes.
METHODS: Details (operative time, length of hospital stay, complications, creatinine at hospital discharge, and creatinine at the 1-month follow-up) were compared between the 32 hand-assisted laparoscopic donor nephrectomy cases and 16 purely laparoscopic donor nephrectomy cases. All parti-cipants were living donors and were first-degree or second-degree relatives of the recipients.
RESULTS: We did not establish superiority of the hand-assisted procedure with regard to all factors except operative time, which we attributed to the challenging learning curve of the laparoscopic method. The laparoscopic method was also associated with a less lengthy hospital stay.
CONCLUSIONS: Both the hand-assisted technique and the laparoscopic technique are safe and effective methods for kidney procurement for transplant. Centers seeking to transition from the first to the second technique can do so smoothly by careful selection of donors and implementation of stepwise changes in both the operative techniques and the postoperative patient treatment.
METHODS: Details (operative time, length of hospital stay, complications, creatinine at hospital discharge, and creatinine at the 1-month follow-up) were compared between the 32 hand-assisted laparoscopic donor nephrectomy cases and 16 purely laparoscopic donor nephrectomy cases. All parti-cipants were living donors and were first-degree or second-degree relatives of the recipients.
RESULTS: We did not establish superiority of the hand-assisted procedure with regard to all factors except operative time, which we attributed to the challenging learning curve of the laparoscopic method. The laparoscopic method was also associated with a less lengthy hospital stay.
CONCLUSIONS: Both the hand-assisted technique and the laparoscopic technique are safe and effective methods for kidney procurement for transplant. Centers seeking to transition from the first to the second technique can do so smoothly by careful selection of donors and implementation of stepwise changes in both the operative techniques and the postoperative patient treatment.
摘要：
目的：在移植中心中缺乏关于供体肾切除术最佳方法的具体证据。我们比较了从手动腹腔镜供体肾切除术方法过渡到纯腹腔镜供体肾切除术方法期间的供体结果，并提供了建议以最大程度地减少初始困难并改善供体结果。
方法：详细信息（手术时间，住院时间,并发症,出院时的肌酐,和1个月随访时的肌酐）在32例手辅助腹腔镜供体肾切除术和16例纯腹腔镜供体肾切除术之间进行了比较。所有参与者都是活体捐赠者，并且是接受者的一级或二级亲属。
结果：除了手术时间外，我们没有确定手辅助手术在所有因素方面的优越性。我们将其归因于腹腔镜方法具有挑战性的学习曲线。腹腔镜方法也与住院时间较短有关。
结论：手助技术和腹腔镜技术都是移植肾脏获取安全有效的方法。寻求从第一种技术过渡到第二种技术的中心可以通过仔细选择供体并在手术技术和术后患者治疗中逐步实施变化来顺利进行。
方法：详细信息（手术时间，住院时间,并发症,出院时的肌酐,和1个月随访时的肌酐）在32例手辅助腹腔镜供体肾切除术和16例纯腹腔镜供体肾切除术之间进行了比较。所有参与者都是活体捐赠者，并且是接受者的一级或二级亲属。
结果：除了手术时间外，我们没有确定手辅助手术在所有因素方面的优越性。我们将其归因于腹腔镜方法具有挑战性的学习曲线。腹腔镜方法也与住院时间较短有关。
结论：手助技术和腹腔镜技术都是移植肾脏获取安全有效的方法。寻求从第一种技术过渡到第二种技术的中心可以通过仔细选择供体并在手术技术和术后患者治疗中逐步实施变化来顺利进行。
