机器人辅助腹腔镜活体供肾切取术31例报告  

Robot-assisted laparoscopic living donor nephrectomy: report of 31 cases

作　　者：阮东丽[1] 张更[1] 李智斌[1] 马帅军[1] 刘克普[1] 高龙[1] 秦卫军[1] 王延柱[1] 杨晓剑[1] 袁建林[1] 

机构地区：[1]第四军医大学西京医院泌尿外科,西安710032

出　　处：《器官移植》2016年第4期275-278,共4页Organ Transplantation

摘　　要：目的评估机器人辅助腹腔镜活体供肾切取术的安全性和有效性。方法回顾性分析2013年11月至2015年8月第四军医大学西京医院实施的31例机器人辅助腹腔镜活体供肾切取术的供、受者的临床资料。结果31例均顺利完成供肾切取术,手术时间110~190 min,术中出血量20~100 ml,供肾热缺血时间100~160 s,保留肾静脉长度1.8~3.0 cm,肾动脉长度1.4~2.3 cm。2例供肾取出时发生脾脏损伤,行脾脏修补术;1例供者术后出血,经止血、纠正贫血后好转。31例供者术后均随访6个月以上,均未发生远期并发症。31例受者中,1例出现移植肾功能延迟恢复,经治疗后于术后1个月血清肌酐恢复正常。移植肾存活率为100%。结论机器人辅助腹腔镜活体供肾切取术具有安全、可靠、创伤小、恢复快、不影响供肾功能等优势,可作为供肾切取有效而安全的手术方式。Objective To evaluate the safety and efficacy of robot-assisted laparoscopic living donor nephrectomy. Methods Clinical data of 31 donors and recipients undergoing robot-assisted laparoscopic living donor nephrectomy in Xijing Hospital of the Fourth Military Medical University from November 2013 to August 2015 were retrospectively analyzed. Results Donor nephrectomy was successfully performed in 31 cases. The operation time ranged from 110 to 190 min. Intraoperative hemorrhage volume was measured as 20-100 ml. The warm ischemia time of the donor kidney was 100 to 160 s. The retained length of renal vein was between 1. 8 and 3. 0 cm and the length of renal artery was1. 4 to 2. 3 cm. In 2 cases,spleen injury occurred during the kidney extraction and was treated with splenorrhaphy. One donor had postoperative hemorrhage,which was treated with hemostasis and anemia correction. Thirty one donors received postoperative follow-up for over 6 months. No long-term complications were observed. Among 31 recipients,one patient had delayed recovery of renal graft function and the serum creatinine level returned to normal range after treatment at postoperative1 month. The survival rate of kidney grafts was up to 100%. Conclusions Robot-assisted laparoscopic living donor nephrectomy is a safe and efficacious surgical procedure for kidney resection,which possesses the advantages of small trauma,rapid recovery and no influence upon renal function.

关 键 词：机器人辅助腹腔镜 供肾切取术 肾移植 活体供肾 

分 类 号：R617[医药卫生—外科学] R616.2[医药卫生—临床医学]