腹腔镜活体供肾切取术(附16例报告)  

Laparoscopic live donor nephrectomy(report of 16 cases)

作　　者：殷长军[1] 张炜大[1] 顾民[1] 张炜小[1] 孟小鑫[1] 吕强[1] 钱立新[1] 华立新[1] 徐正铨[1] 眭元庚[1] 

机构地区：[1]南京医科大学第一附属医院泌尿外科,210029

出　　处：《中华泌尿外科杂志》2005年第10期669-671,共3页Chinese Journal of Urology

摘　　要：目的总结腹腔镜活体供肾切取技术.方法对16例腹腔镜活体供肾切取术资料进行分析.活体供肾者16例,男7例,女9例,年龄36～53岁,平均46岁,均为左侧供肾.受者原发病均为慢性肾小球肾炎.供受者血型相同,淋巴细胞毒性试验均为阴性.结果手术成功15例,1例因术中出血改开放手术.手术时间3.1～5.2 h,出血56～270 ml,平均热缺血时间3.5 min,住院时间9～12 d.16例受者中移植肾功能延迟恢复1例,术后第5周移植肾功能恢复正常;余15例受者血清肌酐均在10 d内降至正常(SCr<146μmol/L),其中出现急性排斥反应1例,应用激素冲击治疗后逆转.结论腹腔镜活体供肾切取手术损伤小,术后恢复快,不影响肾功能.Objective To investigate the technique of laparoscopic live donor nephrectomy （LDN）. Methods The clinical data of 16 cases （7 men and 9 women） of LDN were retrospectively analyzed. Their mean age was 46 years （range ,36 -53 years）. All of them were donors of left nephrectomy. The primary lesion of all recipients was chronic glomerulonephritis. The blood types of donors and recipients were the same. All of the lymphocytotoxicity test results were negative. Results Among the 16 cases of LDN, 15 cases had successful operation. In only 1 case laparoscopy was converted to open surgery due to intraoperative bleeding. The operating time was 3.1 to 5.2 h and blood loss was 56 to 270 ml ;the average warm ischemic time was 3.5 min. The hospital stay of the donors was 9 to 12 d. Of the 16 recipients,only 1 experienced delayed graft function, and recovered 5 weeks postoperatively;in the other 15 recipients, SCr level was normalized （ 〈 146 μmoL/L） within 10 days postoperatively, among them 1 case had acute rejection and recovered by ictus therapy of hormone. Conclusions LDN has the advantages of safety,reliability,minimal invasion,rapid recovery and no effects on allograft function.

关 键 词：腹腔镜活体供肾切取术 肾功能 排斥反应 激素冲击治疗 肾移植术 

分 类 号：R699[医药卫生—泌尿科学]