純粹腹腔鏡活體腎摘取術-十年之經驗

洪啟峰、楊晨洸、賀昊中、蘇重光

台中榮民總醫院 外科部 泌尿外科

 Ten-year experience of pure laparoscopic living donor nephrectomy

Chi-Feng Hung, Cheng-Kuang Yang, Hao-Chung Ho, Chung-Kuang Su

Divisions of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan

Purpose: To report the experience and outcome of pure laparoscopic living donor nephrectomy (LDN), based on the results from a single center during a decade..

Materials and Methods: This is a retrospective review of pure LDNs performed from January 2006 to February 2017. Overall there were 157 pure laparoscopic living donors. Demographic data, operating room time, the number of conversions from laparoscopic to open surgery, donor preoperative glomerular filtration rate and creatinine (Cr), donor and recipient postoperative Cr, delayed graft function and donor complications were analyzed.

Results: 59 female and 98 male living donors with ages ranging from 24 to 65 years underwent left- (n=152), and right-sided (n=5) LDNs. Mean operation time was 120±11 minutes, and mean warm ischemia time 5.45±3.42 minutes. Mean hospital stay was found to be 6.4±2.2 days. No patient needed to switch to open surgery. Subcutaneous hematoma developed in two patients.  Postoperative paralytic ileus developed in two patients.

Conclusions: LDN is a minimally invasive method with advantages of short hospital stay, less analgesic requirement, and better cosmetic results. Even in donors with right kidney or renal vascular anomalies, LDN is a safe and feasible technique.