摘要
目的:报告1例全腹腔镜下右侧自体肾移植术治疗肾动脉狭窄,并总结体会。方法:患者,女性,51岁,诊断为右肾动脉狭窄。术中使用灌注导管通过腹腔镜端口完成体内经动脉低温肾灌注。腹腔镜下完成右侧肾切除及自体肾移植。结果:腹腔镜下右肾切除热缺血时间为2 min,体内低温肾灌注时间为76 min;右肾切除、同侧盆腔内血管吻合总手术时间为301 min。静脉和动脉吻合时间分别为23 min和27 min。估计出血量200 mL。无并发症发生,术后1周复查B超提示移植肾血流信号无异常,皮、髓质界限清晰。术后2周出院。术后1个月CT血管造影检查示移植肾大小、形态正常,移植肾由右侧髂外动脉供血,静脉回流至右侧髂外静脉,动静脉相和排泄相显影良好。核素肾动态显像提示移植肾GFR 36.9 mL·min^-1。结论:全腹腔镜下自体肾移植术治疗肾动脉狭窄安全、可行,可在临床选用。
Objective: To report a case of total laparoscopic right renal autotransplantation in the treatment of renal artery stenosis and summarize the experience. Methods: A 51-year-old female was diagnosed with right renal artery stenosis. Intraoperative perfusion catheter was used to accomplish intra-arterial hypothermic renal perfusion through laparoscopic port. Laparoscopic nephrectomy and autologous kidney transplantation were performed. Results: The warm ischemia time of laparoscopic right nephrectomy was 2 minutes, the hypothermic renal perfusion time was 76 minutes, and the total operation time of right nephrectomy and ipsilateral pelvic vascular anastomosis was 301 minutes. The anastomosis time of vein and artery was 23 minutes and 27 minutes respectively. The estimated blood loss was 200 ml. There were no complications. One week after operation, B-ultrasound showed that the blood flow signal of the transplanted kidney was normal and the boundary between skin and medulla was clear. She was discharged 2 weeks after operation. One month after operation, CT angiography showed that the size and shape of the transplanted kidney were normal. The transplanted kidney was supplied by the right external iliac artery and returned to the right external iliac vein. Radionuclide renal dynamic imaging showed GFR36.9 mL·min^-1 of the transplanted kidney. Conclusions: Total laparoscopic autologous renal transplantation is safe and feasible for the treatment of renal artery stenosis.
作者
许志斌
郭毛毛
卞浩
张波
王江平
XU Zhi-bin;GUO Mao-mao;BIAN Hao;ZHANG Bo;WANG Jiang-ping(Department of Urology,Taizhou People's Hospital,Taizhou,Jiangsu,225300;Department of Urology,Tangdu Hospital,Air Force military Medical University,Xi'an,Shanxi 710000)
出处
《赣南医学院学报》
2019年第12期1241-1243,共3页
JOURNAL OF GANNAN MEDICAL UNIVERSITY
关键词
自体肾移植
腹腔镜
手术治疗
肾动脉狭窄
Autologous Renal Transplantation
Laparoscopic
Surgery
Renal Artery Stenosis
