摘要
目的总结3D后腹腔镜下活体供肾切取术的经验,并探讨其临床效果和安全性。方法收集19例3D后腹腔镜下活体供肾切取术的临床资料。记录手术时间、术中失血量、肾脏热缺血时间、肾动脉长度、肾静脉长度、输尿管长度、切口长度、手术并发症。观察供、受者术后肾功能的情况等。结果 19例活体供肾切取术均在3D后腹腔镜下顺利完成,无术中改为常规腹腔镜和中转开放者。3D后腹腔镜下活体供肾切取术手术时间80.5~125.2（平均102.3）min;术中出血量40.6~90.4（60.8）ml;肾脏热缺血时间100~230（161）s。供肾动脉长度2.6~3.2（2.9）cm;供肾静脉长度2.2~3.0（2.6）cm;供肾输尿管长度8~13（10）cm;切口长度约5~6 cm,伤口愈合良好;供者术后24 h尿量2 000~2 500 ml;术后3 d查血清肌酐轻度增高1例,术后7 d和1个月复查血清肌酐恢复正常。术后住院时间5~7（6）d。移植手术均获成功,未发生移植肾功能延迟恢复。结论 3D腹腔镜手术系统可有效提高术中操作的精准性,3D后腹腔镜下活体供肾切取术安全可行。
Objective To summarize the experience in retroperitoneal living donor nephrectomy under 3D laparoscopy and to investigate its clinical effect and safety. Methods The clinical data of 19 cases who underwent retroperitoneal living donor nephrectomy under 3D laparoscopy were collected. Operation duration,intraoperative blood loss,renal warm ischemia time,length of renal artery,renal vein and ureter,incision size and operative complications were recorded. Postoperative renal function of donors and recipients was observed. Results Nineteen cases of living donor nephrectomy were successfully completed under the 3D laparoscopy, and there were no conversion into conventional laparoscopy and open surgery. The operation duration of living donor nephrectomy under 3D laparoscopy was 80. 5-125. 2（ with an average of 102. 3） min; intraoperative blood loss was 40. 6-90. 4（ 60. 8） ml; renal warm ischemia time was 100-230（ 161） s. Length of renal artery,renal vein and ureter was 2. 6-3. 2（ 2. 9） cm,2. 2-3. 0（ 2. 6） cm and 8-13（ 10） cm,respectively. The incision size was about 5-6 cm,and the wound healed. Urine volume of the donors at 24 h after operation was 2 000-2 500 ml. Serum creatinine increased slightly in 1 case at 3 d after operation,and returned to normal through reexamination after 7 d and 1 month. The donors stayed in the hospital 5-7（ 6） d after operation. All transplant operations were performed successfully,and delayed graft function did not occurred. Conclusions Accuracy of operation can be improved effectively by 3D laparoscopic surgery system. It is safe and feasible to perform retroperitoneal living donor nephrectomy under 3D laparoscopy.
出处
《器官移植》
CAS
CSCD
2016年第4期279-282,共4页
Organ Transplantation
关键词
三维
腹腔镜
活体供肾切取术
活体供肾移植
Three-dimensional
Laparoscopy
Living donor nephrectomy
Living donor renal transplantation
