经腹腔及后腹腔腹腔镜活体亲属供肾切取术(附2例报告)

目的：探讨利用腹腔镜及后腹腔镜技术行活体亲属供肾切取的手术方法，评价其安全性、可行性及临床效果。方法：术前对供、受者进行全面的免疫学检查，并对供者作详细的安全性评价，行SPECT检查了解两侧肾功能，DSA了解肾血管的变异情况。分别采用经腹腔及后腹腔的腹腔镜技术行活体亲属供肾切取，并用常规方法移植给受者。结果：2例均成功切取左肾并移植给受者，热缺血时间分别为6min及5min，血管开放后5min及10min供肾泌尿，无排斥反应及与操作技术有关的并发症，供者术后7d及5d出院，生活能自理，无并发症发生。结论：利用腹腔镜技术行活体亲属供肾切取对供者损伤小，术后康复快，对供肾功能无明显影响，技术上安全和可行。

Laparoscopic live related donor nephrectomy(Report of 2 cases)

Purpose:To investigate the operative techniques of transperitoneal and retroperitoneal laparoscopic live related donor nephrectomy and evaluate their safety, feasibility and clinical effects.Method: The recipents and the donors underwent standard thorough medical evaluation preoperatively, including immunological and imaging investigation. Transperitoneal and retroperitoneal laparoscopic live related donor nephrectomies were performed.Result: The left kidneys of the donors were successfully harvested laparoscopically, the operation time was 200 minutes and 120 minutes , blood loss was 150 ml and 50 ml, warm ischemic time was 6 minutes and 5 minutes,respectively. The allografts were implanted into the recipents and produced urine on the table immediately upon revascularization. To date, there's no rejection and complications related to the techniques, serum creatinine of the recipents decreased rapidly. The donors had a short hospitalization of 7 and 5 days postoperatively.Conclusion: Laparoscopic live related donor nephrectomy can lessen the burden placed on living donor and has few effects on the allograft, the operation is technically feasible and safe.