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腹腔镜手辅助经腹膜供体肾切除术过程中遇到的解剖变异:完全下腔静脉重复一例报告

Anatomic Diversity Encountered During Laparoscopic Hand-Assisted Transperitoneal Donor Nephrectomy: A Case Report of Complete Caval Duplication.

作者信息

Kirecci S L, Demir M, Ilgi M, Battal M, Dokucu A I, Unsal A

机构信息

Organ Transplantation and Urology Clinic, Sisli Hamidiye Etfal Research and Training Hospital, Istanbul, Turkey.

Pediatric Surgery and Organ Transplantation Clinic, Sisli Hamidiye Etfal Research and Training Hospital, Istanbul, Turkey.

出版信息

Transplant Proc. 2017 Apr;49(3):613-615. doi: 10.1016/j.transproceed.2017.01.038.

Abstract

INTRODUCTION

Laparoscopic donor nephrectomy is widely used to retrieve a kidney for transplantation. Preoperative evaluation of the donor is of crucial importance to the recipient. In particular, vascular anatomy should be assessed with the help of modern imaging modalities. We present a hand-assisted laparoscopic nephrectomy of a kidney donor with a complete duplex vena cava.

CASE REPORT

A 40-year-old male patient was admitted to our clinic as a kidney donor for his 20-year-old son. After the preliminary tests, further imaging with the use of computerized tomographic angiography showed a complete duplex vena cava. He had no morbidities or previous surgeries. A hand-assisted transperitoneal laparoscopic left nephrectomy was performed as the kidney removal technique commonly used in our center. There was minimal blood loss, and the warm ischemia time was 66 minutes. Operation time was 265 minutes. After transplantation had been performed, graft functions were good with normal urine output. Blood sample tests were in normal ranges. The live donor was discharged on the 7th day after the procedure without any complications.

CONCLUSIONS

Although renal vascular anomalies are rarely seen, they have a significant impact on the outcomes of the renal transplantation. Knowing the vascular anatomy minimizes the complications risk and increases the success rate. Laparoscopic live-donor nephrectomy can be performed safely, even in patients with vascular anomalies.

摘要

引言

腹腔镜供肾切除术广泛应用于获取供移植的肾脏。供体的术前评估对受体至关重要。特别是,应借助现代成像方式评估血管解剖结构。我们展示了一例具有完整双腔静脉的供肾者的手辅助腹腔镜肾切除术。

病例报告

一名40岁男性患者作为其20岁儿子的肾脏供体入住我们的诊所。经过初步检查,使用计算机断层血管造影进行的进一步成像显示存在完整双腔静脉。他没有疾病史或既往手术史。作为我们中心常用的肾脏切除技术,实施了手辅助经腹腹腔镜左肾切除术。术中失血极少,热缺血时间为66分钟。手术时间为265分钟。移植术后,移植肾功能良好,尿量正常。血液样本检测结果在正常范围内。活体供体在术后第7天出院,无任何并发症。

结论

尽管肾血管异常很少见,但它们对肾移植的结果有重大影响。了解血管解剖结构可将并发症风险降至最低并提高成功率。即使在有血管异常的患者中,腹腔镜活体供肾切除术也可安全进行。

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Novel technique for hand assisted laparoscopic right donor nephrectomy.手辅助腹腔镜右供体肾切除术的新技术
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