摘要
总结后腹腔镜下73例活体供肾切取术的经验,分析临床效果,改进操作技术。回顾性分析后腹腔镜下活体供肾切取术共73例的临床资料、手术操作、手术时间、出血量、术后愈合时间、并发症发生情况和受者肾功能情况等。73例手术均获得成功,手术时间(98.3±22.9)min,1例因过度肥胖、腹膜破裂中转开放。术中出血量(42.1±19.7)ml,所有供者不需输血。供肾热缺血时间(5.2±0.7)min。供者术后住院(6.9±2.0)d。供者发生术后并发症3例,1例为术后肾区血肿,保守治疗后自行吸收;2例为术后乳糜漏,均保守治疗后自行停止。供者术后随访1~33个月,6例出现切口膨出,无需处理;8例出现腰腹部皮肤麻木,在1~6个月自行好转。所有受者肾功能恢复良好。后腹腔镜下活体供肾切取术创伤小、出血少、恢复快、安全可靠,经不断技术改进后已经成熟和标准化,值得临床推广。
To summarize the experience of retroperitoneal laparoscopic living donor nephrectomy（ RLDN）,concerning the safety,compliments and continuous technical improvements. A total of 73 living donors underwent RLDN were employed in this study and clinical data about donors＇ age,sexuality,technology of operation,operative time,volume of blood loss,length of hospital stay,perioperative complications,renal function of recipients after operation were analyzed. All RLDN operations got successful surgeries with the operative time of（ 98. 3 ± 22. 9）min. One case of open surgery transit due to the obesity and peritoneum rupture. The bleeding volume was（ 42. 1± 19. 7） ml and all donors did not receive blood transfusion. The warm ischemia time of donor kidneys was（ 5. 2 ±0. 7） min and mean hospital stay period was（ 6. 9 ± 2. 0） days. One donor was found to have hematoma of renal fossa after operation and did not require further treatment. Two donors were found to have chylous ascites after operation,and they were cured with conservative measures. During the follow up of 1 - 33 months,incision bulging was found in 6 donors,but no one required further treatment. Lumbar and abdominal skin numbness were observed in 8 donors and recovered in 1 - 6 months. All 73 recipients had normal renal function in two weeks. In conclusion,RLDN is a safe procedure with minimal invasiveness,less blood loss,less hospital stay,and it can be an accredited and standardized operation for living kidney transplantation.
作者
朱道方
唐亮
钟金彪
廖贵益
梁朝朝
Zhu Daofang;Tang Liang;Zhong Jinbiao(Dept of Urology,The First Affiliated Hospital of Anhui Medical University,Hefei 23002)
出处
《安徽医科大学学报》
CAS
北大核心
2018年第9期1473-1475,共3页
Acta Universitatis Medicinalis Anhui
基金
国家临床重点专科建设项目(编号:卫医政函[2012]649号)
安徽省自然科学基金(编号:1508085SMH226)
关键词
腹腔镜
活体供肾
肾切除
肾移植
laparoscopes
living donors
nephrectomy
kidney transplantation
