手助腹腔镜肾切除术用于肾移植:手术技术——技巧和窍门——我们是如何做到的?

IF 0.5 4区 医学 Q4 SURGERY Annals of Laparoscopic and Endoscopic Surgery Pub Date : 2022-01-01 DOI:10.21037/ales-22-31
J. Romero, Jorge Meza, Antonio Marmolejo, Roberto Bathory, Ana Paula Ruiz-Funes, Jorge Farell, A. Bandin
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引用次数: 0

摘要

:肾移植被认为是处于肾脏替代治疗或透析阶段的慢性肾脏病患者的最佳治疗方法,它具有更好的生存率和生活质量,发病率更低,长期费用更低,与其他治疗方法相比,为医疗保健系统节省了总体成本。在活体供肾移植患者中,安全性必须始终是最大的优先事项,因为这是在健康的患者身上进行的,为了接受者的利益,他接受了大手术的风险。捐赠过程应该尽可能减少潜在捐赠者的创伤、痛苦和不舒服。多年来,已经描述了几种方法,目前还没有对潜在捐赠者进行肾切除术的黄金标准。与完全腹腔镜手术相比,手辅助腹腔镜肾切除术包含了微创方法的优点,减少了手术时间和学习曲线。这项技术对捐赠者和接受者都显示出了良好的效果。这项工作介绍了手辅助腹腔镜肾切除术的技术描述,重点是解剖学方面、技巧和窍门。此外,还增加了设备偏好卡、患者的检查、术后管理和叙述的技术视频,以便读者能够直观地跟随它们。
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Hand-assisted laparoscopic nephrectomy for a kidney transplant: surgical technique—tips and tricks—how we do it?
: Kidney transplant is considered the best therapy for patients with chronic kidney disease in renal replacement therapy or dialysis stage, which has better survival and quality of life with lower morbidity and lower long-term expenses, resulting in overall cost saving for the health care system compared to other therapies. In a living donor kidney transplant patient, the safety must remain as maximal priority because it is performed on a healthy patient who accepts the risks of major surgery for the benefit of the recipient. The process of donation should be as least traumatic, painful, and uncomfortable as possible to the potential donor. Over the years several approaches have been described, currently there is no gold standard to perform a nephrectomy on potential donors. Hand-assisted laparoscopic nephrectomy encompasses the benefits of the minimally invasive approach reducing the operative time and learning curve in comparison with the totally laparoscopic procedure. This technique has shown excellent results, both for the donor and the recipient. This work presents the technical description of the hand-assisted laparoscopic nephrectomy focused on the anatomical aspects, tips and tricks. Furthermore, the equipment preference card, patient’s workup, postoperative management, and narrated technique video are added so that the reader can follow them visually.
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CiteScore
1.40
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发文量
20
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