Saad S, Arns W, Paul A, Nagelschmidt M, Heiss M, Treckmann J
Klinik für Viszeral-, Gefäss- und Transplantationschirurgie, Krankenhaus Köln-Merheim, Lehrstuhl I Chirurgie der Universität Witten/Herdecke.
Zentralbl Chir. 2008 Apr;133(2):188-92. doi: 10.1055/s-2008-1004740.
In contrast to the USA, laparoscopic donor nephrectomy is rarely practised in German transplant centres. Safety concerns and difficulties with the learning curve of this advanced laparoscopic procedure are the main obstacles to the establishment of this operation.
From 1998-2005, we performed laparoscopic kidney procurement in 50 live kidney donors on an intention to treat basis harvesting a total of 29 left and 21 right kidneys for transplantation.
Negative adverse effects on the donor side were temporary nerve irritation (2 patients) and postoperative retroperitoneal hematoma. Reasons to convert to open nephrectomy were bleeding (2 patients) and adhesions (1 patient). On the recipient side, one kidney was lost due to renal vein thrombosis. Three patients required short-time dialysis after transplantation. All other kidney transplants worked without any problems.
Laparoscopic donor nephrectomy is a safe procedure and has been established as the method of choice for live kidney donation in our hospital.
与美国不同，德国移植中心很少开展腹腔镜供肾切除术。对这种先进腹腔镜手术学习曲线的安全担忧和困难是开展该手术的主要障碍。
1998年至2005年，我们对50例活体供肾者进行了腹腔镜肾脏获取，按意向性治疗原则，共获取29个左肾和21个右肾用于移植。
供体方面的不良影响为暂时性神经刺激（2例患者）和术后腹膜后血肿。转为开放肾切除术的原因是出血（2例患者）和粘连（1例患者）。受体方面，1例肾脏因肾静脉血栓形成而丢失。3例患者移植后需要短期透析。所有其他肾移植均顺利进行，无任何问题。
腹腔镜供肾切除术是一种安全的手术方法，已成为我院活体肾捐献的首选方法。
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