后腹腔镜活体供肾切取193例

发布时间：2018-08-26 10:37

【摘要】：目的:总结后腹腔镜下活体供肾切取术193例的经验,优化改进操作技术,使其更加标准化。方法:选择北京大学第三医院2003年12月至2016年2月行后腹腔镜下活体供肾切取术共193例,全身麻醉下,取腰部3个通道操作,彻底游离肾后,在肾下极7~8 cm处切断输尿管,用endo-cut或hem-o-lok分别夹闭切断肾动静脉,迅速取出肾用4℃肾保存液进行灌注,然后将离体肾保存在冰盐水中准备移植,记录手术时间、出血量、并发症发生情况、供者和受者肾功能情况。结果:193例手术均获得成功,手术时间85 min(55~135 min),1例因出血手术中转开放。术中出血量60 m L(20~200 m L),所有供者均不需输血。供肾热缺血时间2.2 min(2~5 min)。发生供者并发症3例,均为术后肾区血肿,保守治疗均自行吸收,未见不良影响,其余供者均未见异常。供者术后住院5.7 d(4~9 d)。193例供者中162例得到随访,平均随访42个月(1~58个月),均未见异常。2例受者发生移植肾输尿管吻合口漏尿,经手术修补后痊愈;3例受者发生移植肾被膜下血肿。1例受者发生移植肾功能延迟恢复,其余受者肾功能恢复良好。供、受者随访期间肾功能均未见异常。结论:后腹腔镜下活体供肾切取术安全可靠,经不断技术改良后已经成熟和标准化,其应用前景广泛,但应由有经验的医生操作以预防并发症的发生。
[Abstract]:Objective: to summarize the experience of retroperitoneal laparoscopic donor nephrectomy in 193 cases and to optimize and improve the operation technique to make it more standardized. Methods: from December 2003 to February 2016, a total of 193 patients were treated with retroperitoneal laparoscopic nephrectomy. Under general anesthesia, 3 channels of waist were removed and the ureter was cut off at the lower pole of kidney at 78 cm after completely dissociating the kidney. Endo-cut or hem-o-lok were used to cut off the renal artery and vein, and the kidney was quickly taken out and perfused with 4 鈩，

本文编号：2204607