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活体供肾来源的移植肾取石术:供肾前或离体 Bench 程序的系统评价。

Outcomes of Renal Stone Surgery Performed Either as Predonation or Ex Vivo Bench Procedure in Renal Grafts from Living Donors: A Systematic Review.

机构信息

Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy.

Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy.

出版信息

Biomed Res Int. 2020 Nov 27;2020:6625882. doi: 10.1155/2020/6625882. eCollection 2020.

Abstract

AIMS

We aimed to summarize available evidence about intraoperative and postoperative donors' and recipients' outcomes following stone surgery in renal grafts from living donors performed either before donation or as ex vivo bench surgery at the time of living-donor nephrectomy.

METHODS

A systematic review of PubMed, ISI Web of Knowledge, and Scopus databases was performed in September 2020. We included full papers that met the following criteria: original research, English language, human studies, and describing the results of stone surgery in renal grafts from living donors performed either before transplantation or as ex vivo bench surgery.

RESULTS

We identified 11 studies involving 106 patients aged between 22 and 72 years. Predonation and bench stone surgery was performed in 9 (8.5%) and 96 (90.6%) patients, respectively. Predonation stone surgery involved extracorporeal shock wave lithotripsy, retrograde intrarenal surgery, and percutaneous nephrolithotomy in 8, 1, and 1 patient, respectively. The overall success rate of predonation stone surgery was 78%, and the complication rate was 0%. Bench stone surgery involved ureteroscopy, pyelolithotomy, or a combination of both in 79 (82.3%), 10 (10.4%), and 7 (7.3%) cases, respectively, with an overall success rate of 95.8% and an overall complication rate of 9.37%.

CONCLUSIONS

Predonation and bench stone surgery in grafts from living donors represents efficacious and safe procedures. Further studies on wider series with a longer follow-up are required.

摘要

目的

总结活体供肾者在捐献前或活体供肾切除时进行的离体 Bench 手术中接受肾结石手术的供体和受体的术中及术后结局的现有证据。

方法

2020 年 9 月对 PubMed、ISI Web of Knowledge 和 Scopus 数据库进行了系统评价。我们纳入了符合以下标准的全文研究:原始研究、英语、人类研究、描述在移植前或离体 Bench 手术中对活体供肾者的移植肾进行肾结石手术的结果。

结果

我们确定了 11 项研究,涉及 106 名年龄在 22 至 72 岁之间的患者。分别有 9(8.5%)和 96(90.6%)例患者进行了术前和 Bench 结石手术。8 例患者分别接受了体外冲击波碎石术、逆行肾盂内手术和经皮肾镜取石术,1 例患者接受了逆行肾盂内手术,1 例患者接受了经皮肾镜取石术。术前结石手术的总体成功率为 78%,并发症发生率为 0%。Bench 结石手术分别涉及输尿管镜检查、肾盂切开术或两者的联合应用,分别有 79(82.3%)、10(10.4%)和 7(7.3%)例患者接受了该手术,总体成功率为 95.8%,总体并发症发生率为 9.37%。

结论

供体肾在捐献前或离体 Bench 手术中进行肾结石手术是一种有效且安全的方法。需要进一步开展更大系列和更长随访的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f5c/7723480/ba26ab6af9a9/BMRI2020-6625882.001.jpg

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