刘锦科研论文.docVIP

后腹腔镜与开放性活体供肾切取术的疗效对比研究 刘锦1 胡云飞2 徐建1 姜伟 1 (1.武汉大学第一临床学院泌尿外科专业，湖北 武汉 430000；2.武汉大学人民医院泌尿外科，湖北 武汉 430000) ［摘要］目的 总结后腹腔镜与开放性活体供肾切取术的安全性、临床疗效及对移植肾功能的影响。方法 自2008年7月至2012年11月共行活体供肾移植术28例，其中后腹腔镜活体供肾移植术12例（后腹腔镜组），开放性活体供肾移植术16例（开放组）。统计分析两组的供肾切取时间、热缺血时间、手术切口长度、术中失血量、术后进食时间、平均住院日及受体术后肾功能恢复情况。结果 后腹腔镜组与开放组的活体供肾切取的时间、热缺血时间及受体术后移植肾功能的恢复等方面比较，差异没有统计学意义(P0.05)；而供体的手术切口长度、术中失血量、术后进食时间和平均住院日等方面比较，差异具有统计学意义(P0.05)，后腹腔镜组优于开放组。两组平均随访时间：后腹腔镜组为（10.4±3.5）月；开放组为（9.3±3.1）月。术后投入正常日常生活、工作的时间：后腹腔镜组为（21.7±5.4）天；开放组为（29.5±7.3）天，两组间比较有统计学意义(P0.05)。后腹腔镜组与开放组的满意度均为100%。后腹腔镜术后的供体能更早恢复日常生活。结论 后腹腔镜活体供肾切取术具有手术创伤小、术后恢复快、住院时间短的优势，对于手术安全性以及术后对移植肾功能的影响，后腹腔镜术和开放手术之间没有显著差异。 ［关键词］：肾移植；活体供肾切取；后腹腔镜；开放 A comparative study between retroperitoneal laparoscopic live donor nephrectomy and open live donor nephrectomy Liu jin, Hu yun-fei, et al. ( Department of Urology, Renmin Hospital of Wuhan University, Wuhan 430060 ［Abstract］ Objective We report our experience and compare the safety，clinical effect of retroperitoneal laparoscopic live donor nephrectomy and open approach．Method Between Junly 2008 and November 2012，12 kidney donors underwent retroperitoneal laparoscopic live donor nephrectomy and 16 donors underwent live approach．We compare the operating time, warm ischemia time, incision length, blood loss, food intake time, hospitalization time and graft outcomes between the two groups．Result There was no significant difference of mean operating time and warm ischemia time between the two groups (P0.05)．But the results of the incision length, blood loss, food intake time，hospitalization time in the retroperitoneal laparoscopic live donor nephrectomy was better than the open approach．The average follow-up time: Retroperitoneal laparoscopy was (10.4±3.5) months. Open was (9.3±3.1) months. After the operation starting time of the work: Retroperitoneal laparoscopy was (21.7±5.4) days; Open was (29.5±7.3)days; Comparison between the two groups (P0.05). Compared to open live donor nephrectomy，retroperitoneal laparos