关键词:

腹腔镜 , 活体供肾切取术 , 肋下神经 , 肾移植

Abstract:

Objective To study the safety and efficacy of retroperitoneal laparoscopic living donor nephrectomy after freeing subcostal nerve. Methods The clinical data of 126 donors who underwent retroperitoneoscopic living donor nephrectomy in the department of urology，the First Affiliated Hospital of Anhui Medical University from January 2016 to January 2019 were retrospectively analyzed. The donors were divided into two groups depending on whether the subcostal nerve was freed during donor kidneyharvesting，there were 74 donors in the traditional surgery group and 52 donors in the modified surgery group with freeing subcostal nerve. The donor’length of incision，surgery time，intraoperative blood loss，the length of hospitalization，kidney warm ischemia time and visual analogue scale（VAS）at 12 h，24 h and 48 h after surgery were compared between the two groups. Results All patients（n ＝ 126）finished thenephrectomy successfully，and none was transferred to open surgery. The differences in the length of incision，surgery time，kidney warm ischemia time and intraoperative blood loss between the two groups had no statistical significance（P ＞ 0.05）. The postoperative hospital stay was（6.6 ± 1.7）d in the traditional surgery group and（4.8 ± 1.7）d in the modified surgery group，and the difference between the two groups had statistical significance（P ＜ 0.001）. The VAS scores at 12 h，24 h and 48 h after operation in the modified operation group were significantly lower than those in the traditional surgery group，and the differences were statistically significant （P ＜ 0.001）. Conclusion Compared with traditional retroperitoneoscopic surgery，retroperitoneal laparoscopic donor nephrectomy with freeing subcostal nerves is safe and feasible，it can completely preserve the subcostal nerves and shorten the length of hospital stay and short-term postoperative pain.

Key words:

Retroperitoneal laparoscopes , Living donor nephrectomy , Subcostal nerve , Kidney transplantation