Potter Steven R
National Institute of Transplantation, S. Mark Taper Foundation Transplant Center, Los Angeles, California, USA.
Urology. 2006 Nov;68(5):947-51. doi: 10.1016/j.urology.2006.06.019. Epub 2006 Nov 7.
To demonstrate the feasibility of single-surgeon performance of laparoscopic donor nephrectomy and recipient living renal transplantation.
Fifteen consecutive donor-recipient pairs were performed from August 2003 and July 2004 by a single surgeon at one institution. Routine donor and recipient outcome measures were prospectively assessed.
The mean donor height and weight was 66 in. and 151 lb, respectively. All donors underwent left nephrectomy. Renal arteries were paired in 3 (20%) of 15 donors. No donors underwent conversion or transfusion. No donor complications occurred. The mean operating room time, estimated blood loss, and hospital stay was 195 minutes, 200 mL, and 2 days, respectively. The mean recipient height and weight was 65 in. and 158 lb, respectively. The mean recipient age was 46 years (range 21 to 69). Of the 15 recipients, 3 (20%) had previously undergone transplantation. The mean operating room time, blood loss, and hospital stay for the recipients was 155 minutes, 100 mL, and 4.5 days, respectively. No recipient operative complications occurred. All allografts functioned immediately. The median recipient creatinine nadir was 1.1 mg/dL. Of the 15 recipients, 3 (20%) had postoperative complications during follow-up, including reintubation in 1, pneumonia in 1, and acute rejection in 1. The patient and graft survival rate were both 100%, and the mean serum creatinine was 1.16 mg/dL at a mean and median follow-up of 187 and 164 days (range 18 to 350), respectively.
We report the first series evaluating the performance of single-surgeon laparoscopic donor nephrectomy and living renal transplantation. Single-surgeon performance of both laparoscopic donor nephrectomy and living renal transplantation is technically feasible and logistically straightforward. The donor and recipient outcomes are consistent with those reported in published reports.
证明由单一外科医生实施腹腔镜供肾切除术及受体活体肾移植的可行性。
2003年8月至2004年7月，在一家机构由一名外科医生连续完成了15对供受体手术。对供体和受体的常规结局指标进行前瞻性评估。
供体的平均身高和体重分别为66英寸和151磅。所有供体均接受左肾切除术。15名供体中有3名（20%）肾动脉呈双支。无供体中转手术或输血情况。无供体发生并发症。平均手术时间、估计失血量和住院时间分别为195分钟、200毫升和2天。受体的平均身高和体重分别为65英寸和158磅。受体的平均年龄为46岁（范围21至69岁）。15名受体中，3名（20%）曾接受过移植手术。受体的平均手术时间、失血量和住院时间分别为155分钟、100毫升和4.5天。无受体手术并发症发生。所有移植肾均立即发挥功能。受体肌酐最低点的中位数为1.1毫克/分升。15名受体中，3名（20%）在随访期间出现术后并发症，包括1例再次插管、1例肺炎和1例急性排斥反应。患者和移植肾的生存率均为100%，在平均随访187天和中位随访164天（范围18至350天）时，平均血清肌酐为1.16毫克/分升。
我们报告了首个评估单一外科医生实施腹腔镜供肾切除术及活体肾移植的系列研究。单一外科医生实施腹腔镜供肾切除术及活体肾移植在技术上可行且后勤安排简单。供体和受体的结局与已发表报告中的结果一致。
