Tokaç Mehmet, Eren Eryiğit, Özçelik Ümit, Şahin Taylan, Dinçkan Ayhan
Department of General Surgery, İstanbul Aydın University Training and Research Hospital, İstanbul, Turkey.
Department of General Surgery, İstinye University Training and Research Hospital, İstanbul, Turkey.
Transplant Proc. 2019 Sep;51(7):2225-2227. doi: 10.1016/j.transproceed.2019.02.045. Epub 2019 Aug 1.
Ligation of renal hilus is the most important stage of laparoscopic donor nephrectomy. Laparoscopic staplers are securely used for renal pedicle control. We present our donor nephrectomy cases in which we used 1 stapler for renal artery and vein ligation.
Demographic data, number of arteries and veins, ligation types, operation time, and complication rates are recorded.
One hundred twenty laparoscopic donor nephrectomy cases who were operated between December 2017 and August 2018 in İstinye University Hospital and İstanbul Aydın University Hospital were retrospectively evaluated. All of the operations were done by 2 surgeons with a fully laparoscopic method. None of the cases were converted to open nephrectomy. There was 1 renal artery in 110 (91.7%) cases, 2 renal arteries in 9 (7.5%) cases, and 3 arteries in 1 (0.8%) case. Renal artery and vein were ligated with single stapler in 115 (95.8%) cases. Double stapler was used in 5 (4.2%) patients. There were no major complications for donors and no implantation problems for grafts.
Laparoscopic donor nephrectomy is the most used technique for living donor operations. Vascular stapler is securely used for renal artery and vein ligation with high costs. Two or, due to the number of vessels, sometimes 3 staplers are used in the standard technique. In our study, the operation was finished securely in 95.8% of the patients with single stapler use. Single stapler use for ligating renal hilus is safe in kidneys even with suitable multiple arteries and veins in laparoscopic donor nephrectomy.
肾蒂结扎是腹腔镜供肾切除术的最重要阶段。腹腔镜吻合器被安全地用于控制肾蒂。我们展示了我们使用1个吻合器进行肾动脉和静脉结扎的供肾切除术病例。
记录人口统计学数据、动静脉数量、结扎类型、手术时间和并发症发生率。
回顾性评估了2017年12月至2018年8月在伊斯坦布尔医科大学医院和伊斯坦布尔艾登大学医院接受手术的120例腹腔镜供肾切除术病例。所有手术均由2名外科医生采用完全腹腔镜方法完成。无一例转为开放性肾切除术。110例（91.7%）有1条肾动脉，9例（7.5%）有2条肾动脉，1例（0.8%）有3条肾动脉。115例（95.8%）病例使用单个吻合器结扎肾动脉和静脉。5例（4.2%）患者使用双吻合器。供体无重大并发症，移植肾无植入问题。
腹腔镜供肾切除术是活体供肾手术中最常用的技术。血管吻合器被安全地用于肾动脉和静脉结扎，但成本高昂。在标准技术中使用2个或因血管数量有时使用3个吻合器。在我们的研究中，95.8%使用单个吻合器的患者手术顺利完成。在腹腔镜供肾切除术中，即使肾脏有合适数量的多支动静脉，使用单个吻合器结扎肾蒂也是安全的。
