手辅助后腹腔镜供肾切取术多支肾动脉对供受者临床的影响  

Impact of multiple renal arteries on outcomes of renal donors and recipients in hand-assisted retroperito- neoscopic donor nephrectomy

作　　者：罗用文 钱叶勇 范宇 柏宏伟 常京元 李钢 王振 

机构地区：[1]解放军医学院,北京100853 [2]解放军第三0九医院全军器官移植研究所泌尿二科,北京100091

出　　处：《中华器官移植杂志》2016年第1期34-38,共5页Chinese Journal of Organ Transplantation

摘　　要：目的探讨活体供肾多支肾动脉在手辅助后腹腔镜供肾切取术后对供受者临床疗效影响。方法回顾性分析2012年至2014年行手辅助后腹腔镜活体供肾切取术及肾移植的供受者临床资料。结果共纳入121对供受者，多支肾动脉组供者与单支肾动脉组的一般临床资料无差异，手辅助后腹腔镜供肾切取术多支肾动脉组供者与单支肾动脉组供者比较手术时间、失血量、术后并发症、住院时间等无显著性差异，多支肾动脉组比单支肾动脉组供肾冷热缺血长（分别为128．5±13．2min和100．2±17．3min，P〈0．001及196．0±63．3min和154．1±55．2min，P=0．002）。多支肾动脉组受者与单支肾动脉组受者比较手术时间更长（213．5±28．2min和182．2±31．1min，P〈0．001），术中失血量、术后血管并发症、尿路并发症无差异，术后1年内肾功能无差异。结论活体供肾多支肾动脉与单支肾动脉在肾移植术后对供受者临床疗效无差异，不增加供供受者术后并发症，是安全可行的。Objective To analyze the clinical efficacy of multiple renal arteries on outcomes of renal donors and recipients in hand-assisted retroperitoneoscopic donor nephrectomy. Method From 2012 to 2014, 121 patients underwent hand-assisted laparoscopic donor nephrectomy, including 92 cases of a single renal artery and 29 cases of multiple arteries. Donor and recipient outcomes for single artery and multiple arteries allografts were compared. Result The study included 121 pairs of donors and recipients. The demographic characteristics between multiple renal artery group and single renal artery group had no significant difference The operative time, blood loss, postoperative complications, and hospital stay had no significant difference between two groups. Cold ischemia time and warm ischemia time in multiple renal artery group were longer than single donor renal artery group （128.5 ± 13.2 vs 50.2 ± 17.3 min, P〈0. 001 ; 196.0 ± 63.3 vs. 154. 1 ± 55.2 rain, P = 0. 002, respectively）. The operative time in multiple renal artery group was longer than in single renal artery group （213.5 ± 28.2 vs. 182. 2 ± 31.1 min, P〈0. 001 ）. There was no significant difference in blood loss, vascular complications and ureternal complications between two groups. The renal functions of two groups were likewise within one year. Conclusion There was no statistically significant difference in clinical efficacy between hand-assisted retroperitoneoscopic donor nephrectomy with multiple renal arteries and single artery. The use of these grafts was safe for both recipients and donors.

关 键 词：后腹腔镜 肾移植 活体供肾 肾动脉 

分 类 号：R699.2[医药卫生—泌尿科学]