无肝素肋弓下腹膜后腔活体供肾切取术体会

No-heparizated open operation at low costal arch in live donor nephrectomy via retroperitoneal approach

目的探讨肋弓下腹膜后腔无肝素开放切取活体供肾的可行性。方法回顾分析本院2003年5月-2008年5月期间行肋弓下腹膜后腔134例无肝素切取供肾（无肝素组）及82例肝素抗凝切取供肾（肝素抗凝组）效果。结果2组均成功切取活体肾，手术时间110～200min，热缺血时间10～20s，2组移植肾后各有一例出现肾功能延迟恢复（DGF），2组供肾质量比较差异无统计学意义（P〉0．05），但无肝素组出血少。结论肋弓下腹膜后腔无肝素开放切取活体供肾方法安全可靠，供肾质量好，出血少。

Objective To evaluate the possibility of no-heparin open operation at low costal arch in live donor nephrectomy via retropefitoneal approach. Methods The effects of 134 cases no-heparin operation and 82 cases heparinized operation at low costal arch in live donor nephrectomy via retroperitoneal approach during 2003.5 to 2008.5 in our hospital were retrospective analyzed. Results The kidneys of the donors in two groups were successfully harvested. The operation time varied from 110 min to 200 min, and warm isehemia time varied from 10s to 20s. Delayed graft function （DGF） was occurred in one case in each group. There was no significant difference in live donor nephrectomy between the two groups（ P 〉 0. 05）, but the no-heparin group had less bleeding. Conclusion The no-heparin open operation at low costal arch in live donor nephrectomy via retroperitoneal approach is technically feasible and safe, and has less bleeding, and little influence on the allograft.