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活体肝移植中纯腹腔镜供肝切除术的术后健康状况和生活质量。

Postoperative Health Status and Quality of Life After Pure Laparoscopic Donor Hepatectomy for Living Donor Liver Transplantation.

机构信息

Department of Surgery, Yeungnam University College of Medicine, Deagu, South Korea.

Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.

出版信息

Ann Transplant. 2022 Apr 26;27:e935611. doi: 10.12659/AOT.935611.

Abstract

BACKGROUND Laparoscopic donor hepatectomy (LDH) for living donor liver transplantation has been performed in several specialized institutes. Surgical outcomes of LDH have shown comparable results to open donor hepatectomy (ODH), but the quality of life (QOL) after LDH is not known. This prospective questionnaire-based study was performed to assess health status and QOL of live liver donors before and after donor hepatectomy (DH). MATERIAL AND METHODS From May 2017 to February 2020, questionnaire items such as the Enhanced Recovery after Surgery mobility scale (EMS), Body Image Questionnaire, and EQ-5D-3L were examined up to 1 year after DH to respectively evaluate postoperative recovery, body image satisfaction, and health status. RESULTS During the study period, 45 laparoscopic DH (LDH) donors and 2 open DH (ODH) donors were finally fully evaluated. The LDH group had a significantly higher mean EMS than ODH on postoperative day (POD) 5, and 7 (P=0.011, and P=0.004, respectively). Body image scores of the LDH group were significantly higher than that of the ODH group at 1 month after DH (17.8 vs 15.0, P=0.017). There were 45 LDH donors who recovered to preoperative values at 6 months and 1 month after DH, with no statistically significant difference in EQ-5D-3L index value and visual analogue scale (P=0.059 and P=0.217, respectively). CONCLUSIONS Within 1 month after DH, LDH donors showed faster mobility recovery and body image satisfaction to the level of preoperative status than ODH. LDH donors recovered to preoperative health status within 6 months, in accordance with previous studies of ODH donors.

摘要

背景

腹腔镜供体肝切除术(LDH)已在多个专业机构中用于活体供体肝移植。LDH 的手术结果与开放供体肝切除术(ODH)相当,但 LDH 后的生活质量(QOL)尚不清楚。本前瞻性基于问卷的研究旨在评估供体肝切除(DH)前后活体供肝者的健康状况和生活质量。

材料和方法

2017 年 5 月至 2020 年 2 月,对术后恢复量表(EMS)、身体形象问卷和 EQ-5D-3L 等问卷项目进行了检查,直到 DH 后 1 年,分别评估术后恢复、身体形象满意度和健康状况。

结果

在研究期间,最终对 45 例腹腔镜 DH(LDH)供体和 2 例开放 DH(ODH)供体进行了全面评估。LDH 组术后第 5 天和第 7 天的平均 EMS 明显高于 ODH 组(P=0.011 和 P=0.004)。DH 后 1 个月,LDH 组的身体形象评分明显高于 ODH 组(17.8 比 15.0,P=0.017)。45 例 LDH 供体在 DH 后 6 个月和 1 个月恢复到术前值,EQ-5D-3L 指数值和视觉模拟评分无统计学差异(P=0.059 和 P=0.217)。

结论

DH 后 1 个月内,LDH 供体的活动能力恢复和身体形象满意度比 ODH 更快地恢复到术前状态。LDH 供体在 6 个月内恢复到术前健康状况,与 ODH 供体的先前研究一致。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0be8/9055888/6816417ed13b/anntransplant-27-e935611-g001.jpg

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