Retroperitoneal laparoscopic living donor nephrectomy:a report of 22 cases / 器官移植

ABSTRACT

Objective To summarize the experience of retroperitoneal laparoscopic living donor nephrectomy.Methods Clinical data of 22 donors undergoing retroperitoneal laparoscopic living donor nephrectomy in the First Affiliated Hospital of Sun Yat-sen University from January 201 2 to May 201 4 were analyzed retrospectively.The ureter,renal vessel and perirenal fat were dissected by laparoscopic approach.Then the renal vessels were cut off and the kidney was extracted by hand through superomedial inguinal parallel incision.The surgical process and the postoperative follow-up of the donors were recorded.Results One right kidney and 21 left kidneys were extracted.The operations in 22 cases were performed successfully without conversion to laparotomy.The operation time was (1 23 ±31 )min.The length of kidney extracting incision was (7.2 ±0.5)cm.The intraoperative blood loss was 1 5-80 ml and the warm ischemia time was 60-1 50 s.The length of donor renal arteries was 2.0-3.2 cm.The length of renal veins was 1 .0-3.5 cm.The donors were followed up for 1 -21 months.The serum creatinine (Scr)levels at 1 d,1 week and 1 month after operation were (1 20 ±57),(95 ±25),(90 ±21 )μmol/L respectively.Two cases suffered from renal fossa hematoma and poor wound healing after operation respectively.The pain score of the donors was 0-5 at 1 week after operation and 0-1 at 1 month after operation.No donor had the perception that donating kidney had obvious impacts on the general health,but 1 donor felt it had some influence on physical strength.Conclusions It is safe to perform retroperitoneal laparoscopic living donor nephrectomy on the basis of strict donor selection.It has little impacts on the donor's quality of life with small surgical incision and mild postoperative pain.