后腹腔镜活体供肾切取术115例总结  

Retroperitoneal laparoscopic living donor nephrectomy:report of 115 cases

作　　者：赵磊[1] 马潞林[1] 侯小飞[1] 王国良[1] 张荣新[1] 

机构地区：[1]北京大学第三医院泌尿外科,北京100191

出　　处：《中华腔镜泌尿外科杂志（电子版）》2009年第2期1-4,共4页Chinese Journal of Endourology(Electronic Edition)

摘　　要：目的总结后腹腔镜下亲属活体供肾切取术115例的经验。方法我院自2003年12月至2008年11月共行后腹腔镜下亲属活体供肾切取术115例,手术常规取腰部3个穿刺点入路,在肾脂肪囊内游离肾脏后,输尿管游离至肾脏下极7～8cm处剪断,肾动脉和肾静脉用直线切割器(Endo-cut)切断或用hem-o-lok(Weck,USA)夹闭后剪断,立即取出肾脏用4℃肾脏保存液(HCA)灌注肾脏。用直线切割器处理肾血管3例,用hem-o-lok处理肾血管112例。结果115例手术均获得成功,手术时间90min(60～180min)。术中出血量60m(l20～200ml),所有供者不需输血。供肾热缺血时间4.5min(3～8min)。发生手术并发症3例,为术后肾区血肿,均自行吸收,无不良影响,其余供者均无异常。术后住院时间平均为5.7d(4～9d)。115例供者中95例得到随访,平均随访42个月(1～58个月),均健康。结论后腹腔镜下亲属活体供肾切取术安全、可靠,可替代传统开放取肾手术,但要求术者有娴熟的腹腔镜技术。Objective To report our experience of 115 retroperitoneal laparoscopic living donor nephrectomies. Methods A total of 115 donors underwent retroperitoneal laparoscopic living donor nephrectomy from Dec 2003 to Nov 2008. The operation was performed through 3 lumbar ports. After the kidney was liberated fully and the ureter was severed 7-8 cm under the lower pole of kidney, the renal artery and vein were blocked with endo-cut or hem-o-lok separately and then severed. Endo-cut was used in 3 patients and hem-o-lok in 112 donors. Then the kidney was taken out quickly from the donor and infused with 4℃ kidney preserving fluid （HCA） immediately. Results The 115 operations were successful. The mean operative time was 90 min （60-180 min） and blood loss was 60 ml （20-200 ml）. No patient needed blood transfusion. Warm ischemia time was 4.5 min （3-8 min）. 3 patients had hematoma of renal fossa after operation and required no further treatment. Hospital stay after operation was 5.7 days（4-9 days）. 95 of 115 donors were followed up for 42 months （1-58 months）. Conolusion Retroperitoneal laparoscopic living donor nephrectomy is a safe and reliable procedure and it can replace the traditional open surgery.

关 键 词：腹腔镜 活体供者 肾切取术 

分 类 号：R699[医药卫生—泌尿科学]