Cintorino Davide, Pagano Duilio, Bonsignore Pasquale, di Francesco Fabrizio, Li Petri Sergio, Ricotta Calogero, Gruttadauria Salvatore
Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), University of Pittsburgh Medical Center Italy , Palermo, Italy .
J Laparoendosc Adv Surg Tech A. 2017 Jul;27(7):666-668. doi: 10.1089/lap.2017.0140. Epub 2017 May 15.
Renal transplantation is the most successful therapy for improving survival and quality of life for end-stage renal disease (ESRD). Living donor kidney transplantation (LDKTx) has been used as an alternative to reduce the stay on the waiting list of patients with ESRD. Laparoscopic donor nephrectomy (LDN) has become the standard procedure for LDKTx.
This study aims to describe evolution of surgical technique with LDN at our institute.
We retrospectively analyzed our experience with LDN performed from January, 2003 to November, 2016, focusing on describing modifications of the surgical technique and devices made during those years. Demographics, operative factors, and postoperative complications of donors were reviewed.
From the beginning of our experience with LDKTx we have performed 185 cases. From 2003 to 2016, 144 LDN were performed. Modifying our technique in response to the learning curve, complications encountered, and technological advancements, we experienced low complication rates.
Continual refinement with LDN techniques based on intraoperative observations and technological advances is necessary to keep complication rates low and reduce donor morbidity and time for recovery.
肾移植是改善终末期肾病（ESRD）患者生存率和生活质量最成功的治疗方法。活体供肾肾移植（LDKTx）已被用作减少ESRD患者等待名单上停留时间的替代方法。腹腔镜供肾切除术（LDN）已成为LDKTx的标准手术。
本研究旨在描述我院LDN手术技术的演变。
我们回顾性分析了2003年1月至2016年11月期间进行LDN的经验，重点描述了这些年手术技术和器械的改进。回顾了供体的人口统计学、手术因素和术后并发症。
自我们开展LDKTx经验以来，共进行了185例手术。2003年至2016年，共进行了144例LDN。根据学习曲线、遇到的并发症和技术进步对我们的技术进行改进后，我们的并发症发生率较低。
基于术中观察和技术进步对LDN技术进行持续改进，对于保持低并发症发生率、降低供体发病率和缩短恢复时间是必要的。
