后腹腔镜供肾切除术双侧对比：来自中国单中心的经验

Comparison of Both Sides for Retroperitoneal Laparoscopic Donor Nephrectomy: Experience From a Single Center in China.

作者信息

Qiu Y, Wang X, Song T, Rao Z, Liu J, Huang Z, Lin T

机构信息

Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Organ Transplantation Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

出版信息

Transplant Proc. 2017 Jul-Aug;49(6):1244-1248. doi: 10.1016/j.transproceed.2017.02.062.

DOI:10.1016/j.transproceed.2017.02.062

PMID:28735988

Abstract

BACKGROUND

Laparoscopic donor nephrectomy (LDN) has gradually become the main approach to obtain live donor kidneys. However, the shorter right renal vein limits its wider application. The aim of this study was to compare the outcomes of left- and right-side retroperitoneal LDN.

METHODS

We reviewed the perioperative data of 527 consecutive donors receiving retroperitoneal pure LDN with a new method at our center between April 2009 and April 2014. The patients were divided into group A (the first 100 patients) and group B (the remaining 427 patients). A total of 423 cases of left donor surgery and 104 cases of right donor surgery were compared. The comparison of the laterality of LDN was also performed between group A and group B.

RESULTS

This is currently the largest case series of LDN in our country. Although right-side LDN patients had longer operation time and a slightly higher incidence of intraoperative complications compared with left-side LDN patients, the operation time was shorter in both the groups compared with previous reports. In group B, patients undergoing right-side LDN had longer operation time and more frequent complications. Once the learning curve of 100 cases was completed, the incidence of complications and operation time were greatly reduced in both sides for LDN. There was no significant difference in the serum creatinine levels in recipients at 6 months of follow-up.

CONCLUSIONS

Despite a slightly higher incidence of complications and longer operation time, right-side LDN can achieve equally safe and effective transplantation outcomes. This expands the source of potential donor kidneys.

摘要

背景

腹腔镜供肾切除术（LDN）已逐渐成为获取活体供肾的主要方式。然而，右侧肾静脉较短限制了其更广泛的应用。本研究旨在比较左侧和右侧后腹腔镜LDN的手术效果。

方法

我们回顾了2009年4月至2014年4月期间在本中心采用新方法接受后腹腔镜单纯LDN的527例连续供者的围手术期数据。患者分为A组（前100例患者）和B组（其余427例患者）。比较了423例左侧供者手术和104例右侧供者手术。还对A组和B组之间LDN的左右侧别进行了比较。

结果

这是目前我国最大的LDN病例系列。虽然右侧LDN患者与左侧LDN患者相比手术时间更长，术中并发症发生率略高，但与既往报道相比两组的手术时间均较短。在B组中，接受右侧LDN的患者手术时间更长，并发症更频繁。一旦完成100例的学习曲线，LDN两侧的并发症发生率和手术时间都大大降低。随访6个月时受者的血清肌酐水平无显著差异。