Lachkar Salim, Boualaoui Imad, Ibrahimi Ahmed, El Sayegh Hachem, Nouini Yassine
Department of Urology A, Ibn Sina University Hospital, Rabat, MAR.
Cureus. 2024 Oct 2;16(10):e70713. doi: 10.7759/cureus.70713. eCollection 2024 Oct.
Introduction Laparoscopic nephrectomy is the gold standard for kidney removal in living donors, offering advantages such as reduced pain and quicker recovery. In Morocco, where end-stage renal disease (ESRD) is a growing concern, this approach could significantly impact the demand for kidney transplants. This study evaluates the safety and efficacy of laparoscopic live donor nephrectomy in the Moroccan healthcare system. Materials and methods Fifteen laparoscopic nephrectomies were analyzed, focusing on donor demographics, procedure details, and outcomes. Key parameters included donor age, BMI, operative time, warm ischemia time, and blood loss. Complications and graft outcomes were also assessed. Results The procedure was safe and effective, even in obese donors. Donors were predominantly female (80%), with an average age of 49.4 years. Obese donors had longer operative times (282 minutes vs. 220 minutes). Left kidney retrieval was preferred (95%). Warm ischemia averaged 6.27 minutes and blood loss was 207 mL. One donor had elevated creatinine postoperatively, while most maintained stable renal function. Eighteen complications, mostly minor, were reported. Conclusion Laparoscopic live donor nephrectomy is a safe and adaptable procedure in Morocco, offering low complication rates and favorable outcomes. It is effective for a diverse donor population, including older and obese individuals, and may help address the country's growing transplant needs.
引言
腹腔镜肾切除术是活体供肾者肾脏切除的金标准,具有减轻疼痛和恢复更快等优点。在终末期肾病(ESRD)日益受到关注的摩洛哥,这种方法可能会对肾移植需求产生重大影响。本研究评估了摩洛哥医疗系统中腹腔镜活体供肾切除术的安全性和有效性。
材料与方法
分析了15例腹腔镜肾切除术,重点关注供者人口统计学、手术细节和结果。关键参数包括供者年龄、体重指数、手术时间、热缺血时间和失血量。还评估了并发症和移植结果。
结果
该手术是安全有效的,即使对肥胖供者也是如此。供者以女性为主(80%),平均年龄49.4岁。肥胖供者的手术时间更长(282分钟对220分钟)。左肾摘取更受青睐(95%)。热缺血平均为6.27分钟,失血量为207毫升。一名供者术后肌酐升高,而大多数供者肾功能保持稳定。报告了18例并发症,大多为轻微并发症。
结论
在摩洛哥,腹腔镜活体供肾切除术是一种安全且适应性强的手术,并发症发生率低,效果良好。它对包括老年人和肥胖者在内的不同供者群体有效,可能有助于满足该国不断增长的移植需求。