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腹腔镜活体供肾切除术:单中心经验

Laparoscopic live donor nephrectomy: single center experience.

作者信息

Baldan N, Furian L, Ekser B, Fabris L, Broggiato A, Cadrobbi R, Costantini M, Zaninotto G, Rigotti P

机构信息

Dipartimento di Chirurgia Generale e Trapianti d'Organo, U O Trapianti Rene e Pancreas, Azienda Ospedaliera, Università di Padova, Padova, Italy.

出版信息

Transplant Proc. 2007 Jul-Aug;39(6):1787-90. doi: 10.1016/j.transproceed.2007.07.021.

Abstract

AIMS

The aim of this study was a retrospective assessment of the safety of laparoscopic live donor nephrectomy (LLDN) and the outcome of these renal transplantations.

METHODS

From November 2001 to October 2006, we performed 30 LLDN (all left nephrectomies) after excluding any renal vascular anomalies in the donor. All laparoscopic procedures were performed by a team consisting of an expert laparoscopic surgeon and a transplant surgeon. The donor mean age was 48.9 +/- 7.6 years (range 22 to 69), 33% of the donors were men and their mean Body Mass Index was 24.7 +/- 3.8 kg/m(2). The recipients were a 32 +/- 14 years old (range 6 to 64), with 66% of them men, and their mean time on dialysis, 33 +/- 49 months (range 0 to 120).

RESULTS

After a mean follow-up of 39 +/- 14 months, all donors and recipients are alive. The mean operative time was 272 +/- 41 min (range 225-360) and the mean warm ischemia time, 161 +/- 35 seconds (range 107 to 240). Surgical complications in the donors were one incisional hernia and two cases of pneumonia. The donor's mean hospital stay was 5.3 +/- 1.7 days (range 3 to 12) and their mean serum creatinine at discharge was 111 +/- 21 micromol/L. There was one surgical complication-a hematoma-among the recipients, and all transplants functioned immediately except for one case.

CONCLUSIONS

LLDN was confirmed to be safe and effective, with no negative impact on transplants success. Expertise in laparoscopic surgery is needed to minimize the side effects for the transplant donor and for the recipient.

摘要

目的

本研究旨在对腹腔镜活体供肾切除术(LLDN)的安全性及这些肾移植的结果进行回顾性评估。

方法

2001年11月至2006年10月,在排除供体任何肾血管异常后,我们进行了30例LLDN(均为左肾切除术)。所有腹腔镜手术均由一名专家腹腔镜外科医生和一名移植外科医生组成的团队进行。供体平均年龄为48.9±7.6岁(范围22至69岁),33%的供体为男性,其平均体重指数为24.7±3.8kg/m²。受体年龄为32±14岁(范围6至64岁),其中66%为男性,其平均透析时间为33±49个月(范围0至120个月)。

结果

平均随访39±14个月后,所有供体和受体均存活。平均手术时间为272±41分钟(范围225 - 360分钟),平均热缺血时间为161±35秒(范围107至240秒)。供体的手术并发症为1例切口疝和2例肺炎。供体平均住院时间为5.3±1.7天(范围3至12天),出院时平均血清肌酐为111±21微摩尔/升。受体中有1例手术并发症——血肿,除1例病例外,所有移植均立即发挥功能。

结论

LLDN被证实是安全有效的,对移植成功没有负面影响。需要腹腔镜手术专业知识以尽量减少对移植供体和受体的副作用。

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