イワドウ カズヒロ   IWADOH Kazuhiro
  岩藤 和広
   所属   医学部 医学科(東京女子医科大学病院)
   職種   非常勤講師
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 Nine-yr experience of 700 hand-assisted laparoscopic donor nephrectomies in Japan
掲載誌名 正式名:Clinical transplantation
略  称:Clin Transplant
ISSNコード:09020063/13990012
巻・号・頁 26(5),pp.797-807
著者・共著者 Nakajima Ichiro†, Iwadoh Kazuhiro*, Koyama Ichiro, Tojimbara Tamotsu, Teraoka Satoshi, Fuchinoue Shohei
担当区分 2nd著者,責任著者
発行年月 2012/03
概要 OBJECTIVE: We reviewed the introduction of a new, minimally invasive, live kidney donation program in our department. METHODS: The operating times of 700 consecutive hand-assisted laparoscopic donor nephrectomies (HALDN) conducted from February 2001 to April 2010 were examined. The risk factors for prolonging operating times were analyzed and major surgical barriers in HALDN investigated. RESULTS: All procedures were successfully performed without the requirement for conversion to open surgery or blood transfusion. The overall prevalence of perioperative complications was 3.0%, with no mortality, in this non-obese donor population with mean body mass index (BMI) as low as 23.2 +/- 3.2 kg/m(2) . After the initial learning curve, a second learning plateau was detected until around case 300. Multivariate analyses showed that the significant risk factors were male sex, graft weight, number of renal arteries, right nephrectomy, and previous epigastric surgery (p < 0.05). HALDN provided direct handling of the surgical field, secure vascular control, safe manipulation of adhesive tissues, and served to maintain surgical safety. Mean values of the BMI of donors had a significant positive correlation with the prevalence of complications between large studies (p = 0.042). CONCLUSIONS: Laparoscopic donor nephrectomy was safely introduced and established in a single institution with the help of the hand-assistance method.