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首页> 外文期刊>Surgical Endoscopy >Technical considerations and pitfalls in laparoscopic live donornephrectomy.
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Technical considerations and pitfalls in laparoscopic live donornephrectomy.

机译：腹腔镜活体供肾切除术的技术考虑和陷阱。

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摘要

BACKGROUND: Recent developments in laparoscopic solid organ surgery suggest a possible reduction in postoperative discomfort and disability for kidney donors. Technical aspects and the influence of surgical experience in laparoscopic donor nephrectomy were evaluated. METHODS: The clinical outcome of 57 laparoscopic donor nephrectomies (LapNx) was compared with that for a historic control group of 27 open donor nephrectomies (OpenNx). RESULTS: Three conversions to open nephrectomy (5.2%) were necessary. Postoperative complications were minor and comparable in both groups. Patients who underwent laparoscopic surgery demonstrated significantly less postoperative pain and a shorter hospital stay, but operative time and warm ischemia time were significantly longer. Graft survival after LapNx was 100% during a median follow-up period of 13 months. Operative time for LapNx decreased considerably with experience gained and seemed to be less for right nephrectomy. Stenotic ureter-bladder anastomoses occurred after LapNx in four patients during the first half year (7.0%), but this problem seemed to be resolved after modification of the technique. CONCLUSION: LapNx is associated with less postoperative discomfort and improved convalescence.
机译：背景：腹腔镜实体器官手术的最新发展表明，肾脏供体的术后不适和残疾可能会减少。评估了腹腔镜供体肾切除术的技术方面和手术经验的影响。方法：比较了57例腹腔镜供体肾切除术（LapNx）的临床结果与历史对照组（27例开放供体肾切除术（OpenNx））的临床结果。结果：必须进行三次开腹肾切除术（5.2％）。两组的术后并发症均较小，相当。接受腹腔镜手术的患者术后疼痛明显减轻，住院时间缩短，但手术时间和温暖缺血时间明显更长。在13个月的中位随访期内，LapNx移植后的存活率为100％。随着经验的积累，LapNx的手术时间大大减少，而右肾切除术的手术时间似乎更少。在上半年（4％）中，有4例患者在LapNx术后发生了狭窄的输尿管膀胱吻合术，但该问题在技术改良后似乎得以解决。结论：LapNx与术后不适感减轻和恢复期改善有关。

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