手助腹腔镜活体供肾切取术21例报告

目的评价手助腹腔镜活体供肾切取术(HLDN)的手术效果和近期疗效。方法回顾性分析2004年4月至2005年7月采用HLDN方法获取活体供肾21例的临床资料。供者男13例,女8例。年龄31～60岁,平均43岁。其中18例供者为血缘关系亲属供肾,3例为非血缘关系夫妻供肾。通过受者移植后肾功能恢复情况,评价HLDN的效果。结果手术皆取左肾,手术时间100～150 min,失血量30～100 ml。供肾热缺血时间2～3 min,冷缺血时间45～60 min。平均供肾动脉长度2.3 cm,静脉长度3.5 cm。HLDN手术全部成功,无中转开放,无手术并发症,术后6～7 d出院。21例受者肾移植后未发生肾功能延迟恢复,术后1周内肾功能均达到正常值。结论HLDN结合了腹腔镜活体供肾切取术和开放手术活体供肾切取术的优点,既保证了对供者的微创,又保证了供肾质量,有利于推动活体供肾移植的开展。

Hand-assisted laparoscopic live donor nephrectomy (report of 21 cases)

Objective To evaluate the efficiency of hand-assisted laparoscopic technique for live donor nephrectomy and the short-term outcomes for both the donor and recipent.Methods We re- viewed the donor and recipient medical records from 21 consecutive hand-assisted laparoscopic live do- nor nephrectomy(HLDN)from April 2004 to July 2005.Of the 21 donors.13 were male and 8 female. age ranged from 31 to 60 years with a mean age of 43 years.18 cases were living related donors and the other 3 spouse.Results All donors were performed left side nephrectomy.Operating time was 100 to 150 min,estimated blood loss 30-100 ml.Warm ischemia time was 2 3 rain and cold ische- mia time 45-60 rain.The mean length of renal artery and vein were 2.3 cm and 3.5 cm,respectively. The donor's postoperative hospital stay was 6-7 days.Conversion to open nephrectomy and operative complications did not occur.Delayed graft function(DGF)did not happen.The recipient bad normal renal function in postoperative week one.Conclusions HLDN combined the advantages of pure lapa- roscopic live donor nephrectomy(LDN)and open donor nephrectomy(ODN),it appeared not only minimal invasive for donor but also safe for graft.HLDN is a promising new method for live donor ne phrectomy.