后腹腔镜供肾取肾术与开放取肾术式临床效果对比分析  

Comparative analysis of clinical effects between retroperitoneal laparoscopic donor nephrectomy and open donor nephrectomy

作　　者：刘尊伟[1] 张江伟 项和立[1] 田普训[1] 丁小明[1] 潘晓鸣[1] Liu Zunwei;Zhang Jiangwei;Xiang Heli;Tian Puxun;Ding Xiaoming;Pan Xiaoming(Department of Renal Transplantation,the First Affiliated Hospital of Xi’an Jiaotong University,Shaanxi Xi’an 710061,China)

机构地区：[1]西安交通大学第一附属医院肾移植科,陕西西安710061

出　　处：《实用器官移植电子杂志》2024年第5期421-426,共6页Practical Journal of Organ Transplantation(Electronic Version)

基　　金：国家自然科学基金(82201458)。

摘　　要：目的探讨后腹腔镜供肾取肾术与开放取肾术式临床效果优劣。方法回顾性分析2023年1月至2024年4月亲属供肾者的临床资料,男性46例,女性93例,平均年龄为(54.21±6.52)岁。采用后腹腔镜取肾术式99例,采用开放取肾术式40例。收集供肾者既往史、肾脏位置、供肾动脉长度、肾脏维度、动脉支数、手术时间、术中出血量、手术切口长度、术后最高肌酐、术后最高尿素氮、术后住院天数、术后总引流量、供肾取下后动脉长度、热缺血时间、术中腹膜破损及脂肪粘连、并发症情况资料进行分析。结果腹腔镜组手术切口较开放术式组明显缩小、出血量及术后引流量明显减少、供者住院天数明显缩短(P<0.05),热缺血时间较开放术式组明显延长(P<0.05)。男性、体质量指数大、既往吸烟史、外伤史、肾脏维度大、术中出血多、腹膜破损及脂肪粘连会显著增加手术时间(P<0.05)。结论腹腔镜术式在亲属活体供肾取肾术中,在保证肾脏质量前提下,没有延长手术时间,同时具有切口小、出血少、供者恢复快等优点。Objective To explore the clinical effects of retroperitoneal laparoscopic donor nephrectomy and open donor nephrectomy.Methods The clinical data of donors from January 2023 to April 2024 were analyzed retrospectively,including 46 males and 93 females,with an average age of(54.21±6.52)years.Retroperitoneal laparoscopic nephrectomy was used in 99 cases and open nephrectomy was used in 40 cases.Data of donor's past history,kidney position,donor's renal artery length,kidney dimension,number of arteries,operation time,intraoperative blood loss,surgical incision length,postoperative maximum creatinine,postoperative maximum urea nitrogen,postoperative hospitalization days,postoperative total drainage,donor's renal artery length after removal,warm ischemia time,intraoperative peritoneal damage and fat adhesion,and complications were collected and analyzed.Results Compared with the open operation group,the incision of laparoscopic operation was significantly reduced,the amount of bleeding and postoperative drainage were significantly reduced,the hospital stay of donors was significantly shortened(P<0.05),and the warm ischemia time was significantly prolonged(P<0.05).Male,larger body mass index,previous smoking history,trauma history,larger kidney dimension,excessive bleeding during operation,peritoneal damage and fat adhesion significantly increased the operation time(P<0.05).Conclusion On the premise of ensuring the quality of the kidney,laparoscopic operation has the advantages of small incision,less bleeding and quick recovery.

关 键 词：后腹腔镜 供肾取肾术 微创手术 临床效果 

分 类 号：R699.2[医药卫生—泌尿科学]