PDF(Pubmed)
Abstract：
BACKGROUND: Few studies have systematically explored the factors influencing the difficulty of hand-assisted laparoscopic living donor nephrectomy. To investigate the relationship between the difficulty of hand-assisted laparoscopic living donor nephrectomy and postoperative complications of the donor as well as the recipient, and then build a model for predicting the difficulty of surgery.
METHODS: In this study, 60 patients who underwent hand-assisted laparoscopic living donor nephrectomy by the same surgeon from September 2022 to March 2024 were included as the modeling group. 20 patients operated on by another surgeon served as the external validation group. The subjective score (1-3 points) of surgical difficulty was used as the quantitative index of surgical difficulty. Pearson and Spearman correlation tests were used to explore the correlation between preoperative data and surgical difficulty scores of kidney donors, and finally built a prediction model through multiple linear regression analysis.
RESULTS: With the increase in the difficulty of operation, both donors and recipients\' complications were increased. Linear regression analysis showed that only the number of renal arteries, visceral fat thickness and MAP score were independent risk factors for the difficulty of hand-assisted laparoscopic living donor nephrectomy. The prediction equation is as follows: Difficulty score = 0.584*Number of renal arteries + 0.731*MAP score + 0.110*visceral fat thickness.
CONCLUSIONS: Donors with higher surgical difficulty are more likely to have serious complications after surgery as well as the recipient. We also established a reliable prediction model for the difficulty of hand-assisted laparoscopic donor nephrectomy.
METHODS: In this study, 60 patients who underwent hand-assisted laparoscopic living donor nephrectomy by the same surgeon from September 2022 to March 2024 were included as the modeling group. 20 patients operated on by another surgeon served as the external validation group. The subjective score (1-3 points) of surgical difficulty was used as the quantitative index of surgical difficulty. Pearson and Spearman correlation tests were used to explore the correlation between preoperative data and surgical difficulty scores of kidney donors, and finally built a prediction model through multiple linear regression analysis.
RESULTS: With the increase in the difficulty of operation, both donors and recipients\' complications were increased. Linear regression analysis showed that only the number of renal arteries, visceral fat thickness and MAP score were independent risk factors for the difficulty of hand-assisted laparoscopic living donor nephrectomy. The prediction equation is as follows: Difficulty score = 0.584*Number of renal arteries + 0.731*MAP score + 0.110*visceral fat thickness.
CONCLUSIONS: Donors with higher surgical difficulty are more likely to have serious complications after surgery as well as the recipient. We also established a reliable prediction model for the difficulty of hand-assisted laparoscopic donor nephrectomy.
摘要：
背景：很少有研究系统地探讨影响手辅助腹腔镜活体肾切除术难度的因素。探讨手助腹腔镜活体供肾切除术难度与供者及受者术后并发症的关系。然后建立预测手术难度的模型。
方法：在本研究中，从2022年9月至2024年3月，由同一外科医生进行手辅助腹腔镜活体供肾切除术的60例患者作为建模组。由另一名外科医生手术的20名患者作为外部验证组。以手术难度的主观评分(1～3分)作为手术难度的量化指标。采用Pearson和Spearman相关性检验探讨供肾患者术前资料与手术难度评分的相关性,最后通过多元线性回归分析建立了预测模型。
结果：随着手术难度的增加，供者和受者的并发症均增加.线性回归分析显示,仅肾动脉数,内脏脂肪厚度和MAP评分是手助腹腔镜活体供肾切除术困难的独立危险因素。预测方程如下:难度评分=0.584*肾动脉数量+0.731*MAP评分+0.110*内脏脂肪厚度。
结论：手术难度较高的供者与受者一样，更有可能在手术后出现严重并发症。我们还建立了一个可靠的预测模型，用于手辅助腹腔镜供体肾切除术的难度。
方法：在本研究中，从2022年9月至2024年3月，由同一外科医生进行手辅助腹腔镜活体供肾切除术的60例患者作为建模组。由另一名外科医生手术的20名患者作为外部验证组。以手术难度的主观评分(1～3分)作为手术难度的量化指标。采用Pearson和Spearman相关性检验探讨供肾患者术前资料与手术难度评分的相关性,最后通过多元线性回归分析建立了预测模型。
结果：随着手术难度的增加，供者和受者的并发症均增加.线性回归分析显示,仅肾动脉数,内脏脂肪厚度和MAP评分是手助腹腔镜活体供肾切除术困难的独立危险因素。预测方程如下:难度评分=0.584*肾动脉数量+0.731*MAP评分+0.110*内脏脂肪厚度。
结论：手术难度较高的供者与受者一样，更有可能在手术后出现严重并发症。我们还建立了一个可靠的预测模型，用于手辅助腹腔镜供体肾切除术的难度。
