Comparison of Postoperative Outcome of Hepatectomy for Living Donors According to Three Different Incision

Completed

Interventions: Procedure: hepatectomy midline incision
Procedure: hepatectomy conventional incision
Procedure: hepatectomy transverse incision

Brief Summary: Living donor liver transplantation (LDLT) is an important option for patients with end-stage liver disease requiring liver transplantation. When performing LDLT, the safety and well being of donors is of the utmost importance. The conventional incision for donor hepatectomy is a right subcostal incision with a midline extension up to xiphoid. Minimally invasive liver surgery throughout a single 10 cm upper midline incision without laparoscopic assistance has been widely applied and considered to be safe and effective. Recently, laparoscopic and minimally invasive living donor hepatectomy via transverse incision has been suggested to reduce morbidity and the invasiveness of living donor hepatectomy. Although minimally invasive approach has become the surgical method of choice for many transplant centers, little data on comparing the impact of all three different type incision in living liver donors. In our center, the investigators have adopted three different incision according to surgical teams. The investigators undertook this study with the aims of comparing the pain and quality of life of donors according to type of three different incisions and assessing any benefits to the donor due to the smaller midline incision during the early postoperative period.

Recruitment & Eligibility

Inclusion Criteria

Exclusion Criteria

Arm && Interventions

Group	Intervention	Description
MI (midline incision)	hepatectomy midline incision	The living liver donors underwent hepatectomy using upper midline incision (10cm) without laparoscopic assistance
CI (conventional incision)	hepatectomy conventional incision	The living liver donors underwent hepatectomy using right subcostal incision with a midline extension (conventional incision)
TI (transverse incision)	hepatectomy transverse incision	The living liver donors underwent hepatectomy using transverse incision with laparosocpic assistance

Primary Outcome Measures

Name	Time	Method
donor recovery/quality of life (as measure bye the quality of recovery [OoR] score)	postoperative 7 day	QoR (quality of recovery) -15, has recently been developed, which can provide an extensive yet efficient evaluation of postoperative recovery from the patient's perspective \[8\]. The QoR-15 is an abbreviation of the longer and more comprehensive QoR-40 \[15\], and includes questions on pain, physical comfort, physical independence, psychological support and emotional state, and can be completed in approximately 2 minutes.

Secondary Outcome Measures

Name	Time	Method
donor recovery/quality of life (as measure bye the quality of recovery [OoR] score)	postoperative 30 day	QoR (quality of recovery) -15, has recently been developed, which can provide an extensive yet efficient evaluation of postoperative recovery from the patient's perspective \[8\]. The QoR-15 is an abbreviation of the longer and more comprehensive QoR-40 \[15\], and includes questions on pain, physical comfort, physical independence, psychological support and emotional state, and can be completed in approximately 2 minutes.
assessment of subjective pain (as measured by numeric rating scale [NRS]) on postoperative day	1, 4, 8, 24, 48 and 72 h after surgery	numeric rating scale (NRS) in which; 0 = no pain and 100 = worst pain
consumption of analgesics on postoperative day	1, 4, 8, 24, 48 and 72 h after surgery
side effects (nausea, vomiting, back pain, pruritus)	1, 4, 8, 24, 48 and 72 h after surgery	nausea, vomiting, back pain, pruritus
discomfort related to the scar	postoperative 30 day	abdominal wall sensorineural deficits (numbness and differences in tactile and temperature sensations) and tightness around the scar