巨大多囊肾尿毒症患者多囊肾切除同期肾移植术临床分析

Intraperitoneal bilateral nephrectomy followed by kidney transplantation for giant polycystic kidney disease induced uremia

目的探讨多囊肾尿毒症患者经腹腔多囊肾肾切除同期行同种异体肾移植的可行性和安全性。方法5例巨大多囊肾并尿毒症患者行双侧多囊肾切除+同种异体肾移植手术,记录手术情况、并发症及随访结果。结果5例手术过程均顺利,手术时间240~310min,术中出血量248~352mL,双侧多囊肾质量9.5~12.0kg,术后3d胃肠功能恢复,无外科并发症发生,1例术后7d发生急性排斥反应;随访2~30个月,5例患者移植肾功能正常,均存活。结论多囊肾尿毒症患者经腹腔行同期双侧多囊肾切除并原切口行同种异体肾移植安全、可行。

Objective To investigate the feasibility and safety of intraperitoneal bilateral nephrectomy followed by kidney transplantation in patients with giant polycystic kidney disease induced uremia. Methods Five patients with uremia induced by giant polycystic kidney disease underwent intraperitoneal bilateral nephrectomy followed by kidney transplantation via primary incision. The operation, complications and follow-up results were recorded. Results The operation was successfully completed in 5 patients, lasting for 240 to 310 min. The intraoperative blood loss was 248 to 352 mL. The resected bilateral polycystic kidney weighed 9.5 to 12.0 kg. The gastrointestinal function was regained on postoperative day 3, and no surgical complication occurred. Acute rejection occurred in 1 patient on postoperative day 7. The 2-to 30-month follow-up showed the renal allograft function was normal and all patients survived. Conclusion Intraperitoneal bilateral nephrectomy followed by kidney transplantation via primary incision is feasible and safe for the patients with uremia induced by polycystic kidney disease.