后腹腔镜活体供肾切除术：单中心的扩展经验

Retroperitoneoscopic live donor nephrectomy: extended experience in a single center.

作者信息

Tanabe K, Miyamoto N, Tokumoto T, Yamamoto H, Ishida H, Kondo T, Okuda H, Shinmmura H, Shirakawa H, Shimizu T, Ishikawa N, Toma H

机构信息

Section of Renal Transplantation/Renovascular Surgery, Department of Urology, Tokyo Women's Medical University, Tokyo, Japan.

出版信息

Transplant Proc. 2004 Sep;36(7):1917-9. doi: 10.1016/j.transproceed.2004.08.143.

DOI:10.1016/j.transproceed.2004.08.143

PMID:15518698

Abstract

INTRODUCTION

Retroperitoneoscopic live donor nephrectomy (RPLDN) was performed because it is considered to be less invasive than open live donor-nephrectomy (OLDN) or transperitoneal laparoscopic live donor nephrectomy.

PATIENTS AND METHODS

Between July 2001 and May 2003, 118 consecutive live donor kidney grafts were procured using RPLDN or OLDN. The patients who underwent RPLDN were divided into 2 groups: an initial group 1 (n = 38) and a subsequent group 2 (n = 48).Thirty-two patients who underwent OLDN during the same period were used as controls (group 3). The patients were placed in the lateral position. Three retroperitoneoscopic ports were inserted. The kidneys were retrieved through a 5-cm flank incision just below the 11th rib in group 1. In group 2, a 5-cm Pfannenstiel incision was used to extract the kidney.

RESULTS

The operative time was 307 +/- 88 minutes, 245 +/- 42 minutes, and 215 +/- 70 minutes in groups 1, 2, and 3, respectively (group 1 vs group 2 or 3, P < .01). The mean postoperative pentazocine (painkiller) requirements were 12 mg, 4.4 mg, and 22 mg in groups 1, 2, and 3, respectively (group 2 vs group 1 or 3, P < .01). The hospital stay was 6.6 +/- 1.6, 4.9 +/- 0.7, and 7.0 +/- 0.1 days in groups 1, 2, and 3, respectively (group 2 vs group 1 or 3, P < .01). There were no serious complication, such as massive bleeding or bowel injury.

CONCLUSIONS

RPLDN may be safer and less invasive than open donor nephrectomy.

摘要

引言

进行后腹腔镜活体供肾切除术（RPLDN）是因为它被认为比开放活体供肾切除术（OLDN）或经腹腔腹腔镜活体供肾切除术侵入性更小。

患者与方法

在2001年7月至2003年5月期间，连续采用RPLDN或OLDN获取了118例活体供肾移植肾。接受RPLDN的患者分为2组：初始的第1组（n = 38）和随后的第2组（n = 48）。同期接受OLDN的32例患者作为对照组（第3组）。患者取侧卧位。插入3个后腹腔镜端口。第1组通过第11肋下方5厘米的侧腹切口取出肾脏。第2组采用5厘米的耻骨上横切口取出肾脏。

结果

第1、2、3组的手术时间分别为307±88分钟、245±42分钟和215±70分钟（第1组与第2组或第3组相比，P <.01）。第1、2、3组术后平均喷他佐辛（止痛药）需求量分别为12毫克、4.4毫克和22毫克（第2组与第1组或第3组相比，P <.01）。第1、2、3组的住院时间分别为6.6±1.6天、4.9±0.7天和7.0±0.1天（第2组与第1组或第3组相比，P <.01）。未发生严重并发症，如大出血或肠损伤。