腹腔镜亲属活体供肾切取术(附11例报告)

Laparoscopic living related donor nephrectomy:a report of 11 cases.

目的探讨利用腹腔镜技术行亲属活体供肾切取的手术方法和临床体会。方法采用腹腔镜技术对11例活体亲属供肾进行切取,并移植给受者。其中5例采用经腹左肾切除术,2例采用经腹右肾切除术,4例采用经后腹腔右肾切除术。结果手术11例均成功。手术时间60～85 min,平均70.5 min,手术失血量手术失血量45～70 ml,平均55ml,热缺血时间60～130 s,平均95.3 s,肾动脉长2.0～3.5 cm,平均2.8 cm,肾静脉长2～3 cm,平均2.5 cm。供者住院时间5～7 d,平均5.8 d。10例移植患者术后1周肾功能均恢复正常,1例出现肾功能延迟恢复4周后恢复正常。术后无排斥反应及其他与操作技术有关的并发症发生。结论利用腹腔镜技术行活体亲属供肾切取对供者损伤小,术后恢复快,对供肾功能无明显影响,技术上安全可行。

Objective To report the method and clinical experience of laparoscopic living related donor nephrectomy. Methods Consecutive eleven cases of living related donor kidney were procured laparoscopically from year 2004 to 2006 ,right donor kidney of 2 cases and left donor kidney of 5 cases by transperitoneum approach, right donor kidney of 4 cases by postperitoneum approach, then grafted to recipients respectively. Resuits All the operations were successful. The mean operative time was 70.5 minutes （ range from 60 to 85 ）. The estimated blood loss was less than 50 ml in all cases. The mean warm ischemic time was 103.7 seconds （range from 75 -130）. The mean length of artery was 2.8cm（ range from 2 to 3.5 ）. The mean length of vein was 2.5cm（ range from 2 to 3 ）. The mean hospital stay of the donors was 5.8 days （ range from 5 to 7）. Renal function in 10 recipients.was normal one week after the operation. Delayed graft function occurred in one case, and recovered 4 weeks postoperatively. There were no rejection and complications related to the techniques. Conclusion Laparoscopic live donor nephrectomy may lessen the burden placed on living donor and has few effects on the allograft; the operation is technically feasible and safe.