Mak D K C, Ilie C P, Abedin A, Gommersall L, Luscombe C, Golash A
Department of Urology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
J Med Life. 2012 Jun 12;5(2):226-31. Epub 2012 Jun 18.
We report our experience with bilateral hand-assisted laparoscopic nephrectomy in patients with adult polycystic kidney disease.
MATERIALS & METHODS: Between November 2009 and November 2010, 3 patients with adult polycystic kidney disease underwent bilateral hand-assisted laparoscopic nephrectomy in our institution. Indications for bilateral nephrectomy included recurrent cyst hemorrhage, impaired gastrointestinal function and early satiety due to direct intestinal compression by large polycystic kidneys, and anatomical lack of space for future renal transplantation. We retrospectively reviewed the records of these patients and we are reporting our experience.
All three patients successfully underwent bilateral hand-assisted laparoscopic nephrectomy with a mean operating time of 208 minutes (range 195 to 220). There were no conversions to open procedure. Blood loss was less than 100 ml in all cases. Mean renal unit size was of 2037 g (range 1798 to 2214). Hospital stay ranged from 10 to 12 days. One patient developed a chest infection postoperatively and suffered from a prolonged ileus. Another patient developed a retroperitoneal hematoma, which was treated conservatively.
Bilateral hand-assisted laparoscopic nephrectomy is a feasible and safe procedure in adult polycystic kidney disease patients, which has potential benefits of a shorter hospital stay and reduced morbidity and mortality in comparison to open procedure.
我们报告在成年多囊肾病患者中进行双侧手辅助腹腔镜肾切除术的经验。
2009年11月至2010年11月期间，3例成年多囊肾病患者在我院接受了双侧手辅助腹腔镜肾切除术。双侧肾切除的指征包括反复囊肿出血、因巨大多囊肾直接压迫肠道导致的胃肠功能受损和早饱，以及未来肾移植时解剖学上缺乏空间。我们回顾性分析了这些患者的记录并报告我们的经验。
所有3例患者均成功接受了双侧手辅助腹腔镜肾切除术，平均手术时间为208分钟（范围195至220分钟）。无一例转为开放手术。所有病例失血均少于100毫升。平均肾单位大小为2037克（范围1798至2214克）。住院时间为10至12天。1例患者术后发生肺部感染并出现长时间肠梗阻。另1例患者发生腹膜后血肿，经保守治疗。
双侧手辅助腹腔镜肾切除术在成年多囊肾病患者中是一种可行且安全的手术，与开放手术相比，具有缩短住院时间、降低发病率和死亡率的潜在益处。
