Psychosocial and physical impairment after mini-incision open and laparoscopic donor nephrectomy: A prospective study
Psychosocial and physical impairment after mini-incision open and laparoscopic donor nephrectomy: A prospective study
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DOI：
10.1097/01.tp.0000239312.45050.05
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发表时间：
2006-11-27
期刊：
影响因子：
6.2
通讯作者：
IJzermans, Jan N. M.
中科院分区：
文献类型：
--
作者：
Kok, Niels F. M.;Alwayn, Ian P. J.;IJzermans, Jan N. M.
背景。本研究的目的是前瞻性研究小切口供体肾切除术（MIDN）和腹腔镜供体肾切除术（LDN）如何影响供体的生活质量和疲劳。方法。 45 名捐赠者接受了 MIDN，55 名捐赠者接受了 LDN。术前和一年随访期间分别记录简表 36 (SF-36) 和多维疲劳量表 20 (MFI-20) 的生活质量和疲劳情况。结果。 MIDN 和 LDN 后的一年响应率分别为 89% 和 95%。 MIDN 之后，SF-36 的所有尺寸均显着下降。除“活力”（六个月）和“身体疼痛”（12 个月）外，大多数维度在三个月后恢复到术前值。 LDN 后，SF-36 维度的评分在三个月时恢复到术前值，但“活力”和“角色身体”（均为六个月）除外。组间分析显示，术后 1 个月 LDN 后，SF-36 维度“身体功能”（P=0.03）和“身体疼痛”（P=0.04）得分显着提高。在任何时间点，各组之间的疲劳评分都没有显着差异。任何类型的手术后一年内，全身疲劳和身体疲劳 (MFI-20) 仍然受到影响。 MIDN 后，4% 的捐献者在术后 4 周返回工作岗位，而 LDN 后这一比例为 28% (P=0.04)。恢复到术前活动水平在各组之间没有显着差异。结论。这两种手术都明显影响生活质量和疲劳。对生活质量的有益影响和较早重返工作岗位鼓励我们提倡 LDN 作为首选手术方法。
Background. The aim of the present study was to prospectively investigate how mini-incision donor nephrectomy (MIDN) and laparoscopic donor nephrectomy (LDN) affected the donor's quality of life and fatigue.Methods. Forty-five donors underwent MIDN and 55 donors underwent LDN. Quality of life and fatigue were recorded preoperatively and four times during one year follow-up on the Short-Form 36 (SF-36) and Multidimensional Fatigue Inventory-20 (MFI-20), respectively.Results. One-year response rates were 89% and 95% following MIDN and LDN, respectively. After MIDN, all dimensions of the SF-36 significantly declined. Most dimensions returned to preoperative values at three months except for "vitality" (six months) and "bodily pain" (12 months). After LDN, the scores of the SF-36 dimensions returned to preoperative values at three months, except for "vitality" and "role physical" (both six months). Between-groups analysis revealed significantly better scores of the SF-36 dimensions "physical function" (P=0.03) and "bodily pain" (P= 0.04) following LDN at one month postoperatively. Fatigue scores did not significantly differ between the groups at any point in time. General and physical fatigue (MFI-20) remained affected up to one year after either type of surgery. After MIDN, 4% of the donors had returned to work at four weeks postoperatively versus 28% after LDN (P=0.04). Return to preoperative activity level was not significantly different between groups.Conclusions. Both procedures clearly impact quality of life and fatigue. The beneficial effect on the quality of life and the earlier return to work encourage us to advocate LDN as the surgical approach to be preferred.