Volume 5 Issue 2
Mar.  2014
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Li Tao, Fu Shengjun, Dong Zhilong, et al. System evaluation of hand-assisted laparoscopic and open living donor nephrectomy[J]. ORGAN TRANSPLANTATION, 2014, 5(2): 68-73. doi: 10.3969/j.issn.1674-7445.2014.02.003
Citation: Li Tao, Fu Shengjun, Dong Zhilong, et al. System evaluation of hand-assisted laparoscopic and open living donor nephrectomy[J]. ORGAN TRANSPLANTATION, 2014, 5(2): 68-73. doi: 10.3969/j.issn.1674-7445.2014.02.003
shu

System evaluation of hand-assisted laparoscopic and open living donor nephrectomy

doi: 10.3969/j.issn.1674-7445.2014.02.003

  • Institute of Urology of Lanzhou University, Department of Urology, the Second Hospital of Lanzhou University, Clinical Center of Diseases of Urological System in Gansu Province, Key Laboratory of Diseases of Urological System in Gansu Province, Lanzhou 730030, China

  • Received Date: 2014-01-07
    Available Online: 2021-01-26
  • Publish Date: 2014-05-15
    Abstract
  •   Objective   To evaluate the safety and effectiveness of hand-assisted laparoscopic donor nephrectomy (HLDN) and open donor nephrectomy (ODN) systematically.   Methods   Literatures of randomized controlled trials (RCT) about HLDN and ODN were searched in Pubmed, Sciverse, Cochrone Library, China National Knowledge Infrastructure(CNKI), China Scientific Journal Database(VIP), China Biology Medicine(CBM), and Wangfang Database through internet. According to the inclusion and exclusion criteria, 2 reviewers screened the literatures independently, and Meta-analysis was conducted by software RevMan 5.2.   Results   A total of 10 RCTs including 1 230 patients were eligible after screening.Compared with ODN, the Meta-analysis revealed that HLDN possessed significantly longer operation duration and warm ischemia time [pooled odds ratio(OR)=35.81,95% confidence interval(CI):13.98-57.65, P=0.001; pooled OR=43.99, 95%CI: 32.31-55.66, P<0.00001), but less intraoperative blood loss(pooled OR=-78.90, 95% CI: -123.59--34.22, P=0.0005), lower incidence of complications (pooled OR=0.58, 95%CI: 0.39-0.86, P=0.006), and shorter hospital length of stay ［weight mean difference (WMD)=-1.15, 95%CI:-1.40--0.90, P<0.00001]. There was no significant difference in the time of taking normal diet between two groups(WMD=-0.11, 95%CI:-0.67 --0.45, P=0.70).   Conclusions   Compared with ODN, HLDN can improve the safety of operation and reduce the difficulty of operation. It is worthy of clinical promotion and application.

     

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