A novel difficulty grading system for laparoscopic living donor nephrectomy
| Autor: | Jan N. M. IJzermans, Khe T. C. Tran, Kosei Takagi, Hendrikus J. A. N. Kimenai, Robert C. Minnee, Türkan Terkivatan |
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| Přispěvatelé: | Surgery |
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Nephrectomy Article Living donor nephrectomy Education Kidney transplantation Postoperative Complications Internal medicine medicine Humans Living donors Grading (education) Laparoscopy Learning curve Aged Retrospective Studies medicine.diagnostic_test business.industry Teaching Hand-assisted laparoscopy Odds ratio Middle Aged Hepatology medicine.disease Surgery Female business Abdominal surgery |
| Zdroj: | Surgical Endoscopy Surgical Endoscopy, 35(6), 2889-2895. Springer New York |
| ISSN: | 1432-2218 0930-2794 |
| DOI: | 10.1007/s00464-020-07727-w |
| Popis: | Background Several difficulty grading systems have been developed as a useful tool for selecting patients and training surgeons in laparoscopic procedures. However, there is little information on predicting the difficulty of laparoscopic donor nephrectomy (LDN). The aim of this study was to develop a grading system to predict the difficulty of LDN. Methods Data of 1741 living donors, who underwent pure or hand-assisted LDN between 1994 and 2018 were analyzed. Multivariable analyses were performed to identify factors associated with prolonged operative time, defined as a difficulty index with 0 to 8. The difficulty of LDN was classified into three levels based on the difficulty index. Results Multivariable analyses identified that male (odds ratio [OR] 1.69, 95% CI 1.37–2.09, P 28 (OR 1.36, 95% CI 1.08–1.72, P = 0.009), pure LDN (OR 1.99, 95% CI 1.53–2.60, P P P P P P = 0.04) and the intermediate difficulty group (3.0%, P = 0.27). No significant difference in major complications was found between the groups. Conclusion We developed a novel grading system with simple preoperative donor factors to predict the difficulty of LDN. This grading system may help surgeons in patient selection to advance their experiences and/or teach fellows from simple to difficult LDN. |
| Databáze: | OpenAIRE |
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