Olakkengil Santosh A, Rao M Mohan
Departments of Surgery/Renal Unit, The Queen Elizabeth Hospital, South Australia, Australia.
JSLS. 2011 Apr-Jun;15(2):208-12. doi: 10.4293/108680811X13071180406637.
Laparoscopic donor nephrectomy was introduced into Australia in 1997 by this unit. However, some donors may be considered unsuitable, and few modifications to the existing technique can tailor this procedure for an individual donor. Recently, further changes including clustering of ports and single-port methods have been investigated.
The laparoscopic method was offered to all but 3 donors from May 1997 to October 2009. Data were collected on all 289 donors who underwent laparoscopic procedures.
All but 5 donor procedures were completed laparoscopically, and in 4 of them conversion to open was necessary due to hemorrhage. The fifth was a planned conversion in our first right LDN. Delayed graft function was seen in 7 recipients and 5 required dialysis postoperatively. Two kidneys were lost due to arterial thrombosis, and 5 patients underwent segmental infarction with decreased renal function. Mean hospital stay was 2.35±1.67 days. There were no donor deaths or serious morbidity.
Although the benefits to the donor of the laparoscopic method are well recognized, our modifications will benefit those who may be precluded from this method.
1997年，本医疗团队将腹腔镜供肾切除术引入澳大利亚。然而，有些供体可能被认为不适合，对现有技术进行一些改进可使该手术适用于个体供体。最近，包括端口聚集和单端口方法在内的进一步变革也已得到研究。
1997年5月至2009年10月期间，除3名供体外，其他所有供体均采用腹腔镜手术方式。收集了接受腹腔镜手术的289名供体的所有数据。
除5例供体手术外，其他所有手术均通过腹腔镜完成，其中4例因出血而转为开放手术。第5例是我们首例右侧腹腔镜供肾切除术的计划性中转手术。7名受者出现移植肾功能延迟恢复，5名术后需要透析。2个肾脏因动脉血栓形成而丢失，5名患者发生节段性梗死，肾功能下降。平均住院时间为2.35±1.67天。没有供体死亡或严重并发症。
虽然腹腔镜手术对供体的益处已得到充分认可，但我们的改进将使那些可能无法采用该方法的供体受益。
