Kapoor Anil, Lambe Shahid, Kling Ashley L, Piercey Kevin R, Whelan Paul J
Department of Renal Transplant, McMaster Institute of Urology, Canada.
Urol Ann. 2011 May;3(2):62-5. doi: 10.4103/0974-7796.82169.
Data of laparoscopic donor nephrectomy (LDN) with multiple renal arteries for donor and recipient outcomes were reviewed, with the aim of clarifying whether the laparoscopic approach is safe in the presence of multiple renal arteries.
All donor nephrectomies performed at our institution from 2004 to 2008 were reviewed retrospectively. Results were compared between LDN kidneys with multiple arteries and those with a single renal artery.
Out of 171 donor nephrectomies, 21 (12%) were performed for kidneys with multiple renal arteries. All of the 150 (88%) donor nephrectomies in the single vessel group were performed laparoscopically. In the multiple artery group, 9 (43%) underwent an open procedure while 12 (57%) underwent a laparoscopic procedure. The warm ischemia time was longer in the multiple artery group than the single artery group, but the difference was not statistically significant (4.25±0.87 min vs. 4.12±0.95 min, respectively). Regarding transplant recipients, the vascular anastomosis time was similar in both groups (30±4.6 min vs. 29.5±3.7 min). The operative blood loss in the transplant recipients was significantly more in the multiple artery group compared to the single artery group (339±292 ml and 130.7±44.8 ml, respectively; P=0.03). The recipient renal function was similar for both the groups at postoperative day 7, 1 month, and at 1 year.
The data support the fact that the laparoscopic approach to donor nephrectomy in the presence of multiple renal arteries can be performed safely with adequate laparoscopic experience.
回顾关于供体和受体结局的多支肾动脉腹腔镜供肾切除术（LDN）的数据，旨在阐明在存在多支肾动脉的情况下腹腔镜手术方法是否安全。
回顾性分析2004年至2008年在本机构进行的所有供肾切除术。比较多支动脉LDN肾与单支肾动脉LDN肾的结果。
在171例供肾切除术中，21例（12%）是针对有多支肾动脉的肾脏进行的。单支血管组的150例（88%）供肾切除术均通过腹腔镜进行。在多支动脉组中，9例（43%）采用开放手术，12例（57%）采用腹腔镜手术。多支动脉组的热缺血时间比单支动脉组长，但差异无统计学意义（分别为4.25±0.87分钟和4.12±0.95分钟）。对于移植受者，两组的血管吻合时间相似（分别为30±4.6分钟和29.5±3.7分钟）。与单支动脉组相比，多支动脉组移植受者的术中失血量明显更多（分别为339±292毫升和130.7±44.8毫升；P=0.03）。两组在术后第7天、1个月和1年时受者的肾功能相似。
数据支持这样一个事实，即对于有多支肾动脉的供肾切除术，在具备足够腹腔镜经验的情况下，腹腔镜手术方法可以安全进行。
