实用器官移植电子杂志

实用器官移植电子杂志 ›› 2024, Vol. 12 ›› Issue (5): 421-426.DOI: 10.3969/j.issn.2095-5332.2024.05.009

• 论著 • 上一篇    下一篇

后腹腔镜供肾取肾术与开放取肾术式临床效果对比分析

刘尊伟，张江伟，项和立，田普训，丁小明，潘晓鸣   

  1. 西安交通大学第一附属医院肾移植科，陕西 西安 710061

  • 出版日期:2024-09-20 发布日期:2024-09-20
  • 基金资助:

    国家自然科学基金（82201458） 

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

Liu Zunwei，Zhang Jiangwei，Xiang Heli，Tian Puxun，Ding Xiaoming，Pan Xiaoming.    

  1. Department of Renal Transplantation， the FirstAffiliated Hospital of Xi’an Jiaotong University， Shaanxi Xi’an 710061，China.

  • Online:2024-09-20 Published:2024-09-20

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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。

关键词:

后腹腔镜 , 供肾取肾术 , 微创手术 , 临床效果

Abstract:

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 bloodloss， 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 Comparedwith 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. 

Key words:

Retroperitoneal laparoscopic,  , Donor nephrectomy,  , Minimally invasive surgery,  , Clinical effects ,

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