Measuring surgical recovery: The study of laparoscopic live donor nephrectomy
Measuring surgical recovery: The study of laparoscopic live donor nephrectomy
复制标题
DOI：
10.1111/j.1600-6143.2005.01054.x
复制
发表时间：
2005-10-01
影响因子：
8.8
通讯作者：
Fried, GM
中科院分区：
文献类型：
--
作者：
Bergman, S;Feldman, LS;Fried, GM
在腹腔镜供体肾切除术(LDN)后，仅用传统的结果来研究恢复情况，主观性的，并受到共病和心理社会变量的混淆。本研究的目的是使用标准化的、经过验证的器械评估LDN术后的手术恢复情况，并将这一恢复情况与传统方法获得的恢复情况进行比较。这是一项前瞻性研究，研究对象为2001年9月至2004年1月期间在同一机构接受LDN治疗的患者(n=35)。分别于术前和术后4周采用6min步行试验(6MWT)评定功能运动能力，采用简明36问卷(SF-36)评定健康相关生活质量，包括躯体部分(PCS)和精神部分(MCS)评分。确定患者对恢复和恢复正常活动时间的自我评估。在随访(中位数29天)时，患者的6MWT降低了中位数30m(p=0.07)，PCs从57.1降至42.3(p=0.0001)，而MCS保持不变。总体而言，住院时间、恢复活动和患者状态恢复不足以作为以6MWT和PCS为参考标准对患者康复进行分类的结果。LLDN后四周，患者已恢复到基线运动能力，但不是基线一般身体健康。传统的复苏衡量标准是对复苏的不完整描述。
Following laparoscopic donor nephrectomy (LDN), recovery has only been studied using traditional outcomes, subjective and confounded by comorbidity and psychosocial variables. The purpose of this study is to estimate surgical recovery following LDN using standardized, validated instruments and to compare this recovery profile to that obtained with traditional measures. This was a prospective study of patients undergoing LDN at a single institution between September 2001 and January 2004 (n = 35). At baseline and 4 weeks following surgery, functional exercise capacity was measured using the 6-min walk test (6MWT) and health-related quality of life was assessed with the Short Form-36 (SF-36) questionnaire, including physical component summary (PCS) and mental component summary (MCS) scores. Patients' self-assessment of recovery and time to resumption of regular activities was ascertained. At follow-up (median 29 days), patients' 6MWT was lower by a median of 30 m (p = 0.07) and PCS decreased from 57.1 to 42.3 (p = 0.0001), whereas MCS remained constant. Overall, length of stay, return to activities and patient-stated recovery were inadequate outcomes for classifying patient recovery using 6MWT and PCS as the reference standards. Four weeks following LLDN, patients have returned to baseline exercise capacity, but not baseline general physical health. Traditional measures of recovery are incomplete descriptors of recovery.