Department of Urology and Transplantation Surgery, Smt. G R Doshi and Smt. K M Mehta Institute of Kidney Diseases and Research Centre and Dr H L Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India.
Am J Transplant. 2011 Jun;11(6):1320-4. doi: 10.1111/j.1600-6143.2011.03512.x. Epub 2011 Apr 12.
Laparoscopic donor nephrectomy has the advantages of less pain, early ambulation and shorter hospitalization compared to open donor nephrectomy. Kidney recipient surgery is, however, traditionally performed by open surgery. Our aim was to study feasibility and safety of laparoscopic kidney transplantation (LKT). After permission from Internal Review Board, LKT was performed in four patients. All kidneys were procured from deceased donors. Left kidney was used for LKT and transplanted in left iliac fossa while right kidney was used for standard open kidney transplantation (OKT). All transplantation procedures were performed successfully. Cold ischemia time varied between 4 h and 14 h. For LKT, mean time for anastomosis was 65 (range 62-72) min, mean operative time was 3.97 (range 3.5-5) h, mean blood loss was 131.25 mL (range 45-350) mL. Mean wound length was 7 cm in LKT group and 18.4 cm in OKT group. Delayed graft function was observed in one patient in each group. One patient was lost in OKT group due to posttransplant bacterial meningitis. At 6 months, both groups have comparable value of serum creatinine. In conclusion, LKT is technically feasible and safe. Long term outcome needs to be evaluated in a larger study.
腹腔镜供肾切除术与开放性供肾切除术相比，具有疼痛少、早期活动和住院时间短的优点。然而，肾移植受者手术传统上采用开放性手术。我们的目的是研究腹腔镜肾移植（LKT）的可行性和安全性。在获得内部审查委员会的许可后，我们对 4 名患者进行了 LKT。所有肾脏均来自于已故的供体。左肾用于 LKT，并移植到左髂窝，而右肾用于标准的开放性肾移植（OKT）。所有移植手术均成功完成。冷缺血时间在 4 小时至 14 小时之间。对于 LKT，吻合术的平均时间为 65 分钟（范围为 62-72 分钟），手术的平均时间为 3.97 小时（范围为 3.5-5 小时），平均失血量为 131.25 毫升（范围为 45-350 毫升）。LKT 组的平均切口长度为 7 厘米，OKT 组为 18.4 厘米。两组均有 1 例患者出现移植后肾功能延迟恢复。在 OKT 组，1 例患者因移植后细菌性脑膜炎而丢失。6 个月时，两组的血清肌酐值相当。总之，LKT 在技术上是可行且安全的。需要在更大的研究中评估长期结果。
