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[同期腹腔镜双侧肾切除术作为常染色体显性多囊肾病患者肾移植的术前准备]

[Simultaneous laparoscopic bilateral nephrectomy as a preparation for kidney transplantation in patients with autosomal dominant polycystic kidney disease].

作者信息

Shabunin A V, Seregin A V, Seregin A A, Jr Jr, Drozdov P A, Nesterenko I V, Loran O B

机构信息

S.P. Botkin City Clinical Hospital, Moscow, Russia.

Department of Urology and Surgical Andrology, Russian Medical Academy of Continuous Professional Education, Moscow, Russia.

出版信息

Urologiia. 2020 Dec(6):19-22.

Abstract

AIM

to study the possibility and safety of performing simultaneous bilateral laparoscopic nephrectomy in symptomatic patients with autosomal dominant polycystic kidney disease (ADPKD) as a preparation for kidney transplantation.

MATERIALS AND METHODS

From May 2018 to September 2019, six symptomatic patients with end-stage renal disease caused by ADPKD, who had hemodialysis, underwent simultaneous bilateral laparoscopic nephrectomy. The mean vertical kidney size according to CT data was 211.67+/-37.15 mm, the mean horizontal size was 145.36+/-19.53 mm. In 5 cases, the hand-assisted procedure was performed.

RESULTS

The average duration of the procedure was 225.1+/-40.37 minutes. Postoperative complications were recorded in 2 (33.2%) patients. The average length of stay was 8.83+/-2.13 days. There were no clinical manifestations of adrenal insufficiency. All patients are alive. In two patients, cadaveric kidney transplantation was performed after laparoscopic bilateral nephrectomy.

CONCLUSION

Laparoscopic bilateral nephrectomy in patients with chronic renal failure associated with ADPKD is feasible, safe and is associated with a short length of stay. This procedure improves the quality of life of patients and facilitates subsequent kidney transplantation.

摘要

目的

研究对有症状的常染色体显性多囊肾病(ADPKD)患者同期进行双侧腹腔镜肾切除术作为肾移植准备的可能性和安全性。

材料与方法

2018年5月至2019年9月,6例因ADPKD导致终末期肾病且已进行血液透析的有症状患者接受了同期双侧腹腔镜肾切除术。根据CT数据,肾脏平均垂直大小为211.67±37.15mm,平均水平大小为145.36±19.53mm。5例采用了手辅助手术。

结果

手术平均时长为225.1±40.37分钟。2例(33.2%)患者出现术后并发症。平均住院时间为8.83±2.13天。无肾上腺功能不全的临床表现。所有患者均存活。2例患者在腹腔镜双侧肾切除术后接受了尸体肾移植。

结论

对与ADPKD相关的慢性肾衰竭患者进行腹腔镜双侧肾切除术是可行、安全的,且住院时间短。该手术可改善患者生活质量并便于后续肾移植。

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