Fabián J F, Mancilla E, Aburto J S, Kasep J, Lopez J O, Almaguer F, Basilio C I, García H B, Arcos A G
Department of Nephrology and Kidney Transplantation, Instituto Nacional de Cardiología "Dr. Ignacio Chávez", México.
Department of Nephrology and Kidney Transplantation, Instituto Nacional de Cardiología "Dr. Ignacio Chávez", México.
Transplant Proc. 2016 Mar;48(2):568-71. doi: 10.1016/j.transproceed.2016.02.020.
The live donor nephrectomy is an unusual surgical procedure as it is performed on healthy individuals. It is important to make the procedure as safe as possible without compromising the health of the donor and graft function.
In Mexico during 2014, 2610 kidney transplantations performed, and 1862 grafts were from living donors.
We describe our experience with hand-assisted laparoscopic nephrectomy on live donors for kidney transplantation.
We present a descriptive and observational study in which all living donors who completed the study protocol for renal transplantation are included.
From September 2006 to July 2015, there were 238 hand-assisted laparoscopic nephrectomies with live donors; 227 (95.37%) were performed on the left side and 11 (4.63%) on the right side. Of donors, 54.1% were females. The average values for the variables analyzed were age 38.17 years, 25.94 BMI, creatinine 0.82-1.13 mg/dL pre- and postoperative month respectively, length of stay 4.95 (range 2-8), warm ischemia 5.07 (range 3-13) minutes, surgical time 168.85 minutes (range 90-306), and transsurgical bleeding 139 055 mL (range 25-650). One patient was reoperated for abdominal pain and bloating without evidence of pathology, attributing it to metabolic ileus. Two patients were converted to open surgery; 1 by technical problems with the laparoscopic equipment and the second by bleeding from the renal vein, both with good results.
Laparoscopic nephrectomy is a safe method that allows kidney donors to have a speedy recovery without modifying the survivals of renal grafts.
活体供肾肾切除术是一种不寻常的外科手术，因为它是在健康个体身上进行的。在不损害供体健康和移植肾功能的前提下，尽可能确保手术安全非常重要。
2014年在墨西哥，共进行了2610例肾移植手术，其中1862例移植肾来自活体供体。
我们描述了在活体供肾肾移植中应用手辅助腹腔镜肾切除术的经验。
我们开展了一项描述性观察性研究，纳入了所有完成肾移植研究方案的活体供体。
2006年9月至2015年7月，共进行了238例手辅助腹腔镜活体供肾肾切除术；227例（95.37%）在左侧进行，11例（4.63%）在右侧进行。供体中54.1%为女性。所分析变量的平均值分别为：年龄38.17岁，体重指数25.94，术前和术后1个月肌酐分别为0.82 - 1.13mg/dL，住院时间4.95天（范围2 - 8天），热缺血时间5.07分钟（范围3 - 13分钟），手术时间168.85分钟（范围90 - 306分钟），术中出血139.055mL（范围25 - 650mL）。1例患者因腹痛和腹胀接受再次手术，未发现病理证据，归因于代谢性肠梗阻。2例患者转为开放手术；1例因腹腔镜设备技术问题，另1例因肾静脉出血，二者效果均良好。
腹腔镜肾切除术是一种安全的方法，可使供肾者快速康复，且不影响移植肾的存活。
