Clinical Application Of Retroperitoneal Laparoseopic Living Donor Nephrectomy

Backgroud:Globally, the incidence of uremia is continuously rising. According to information statistics, About100-100per one million people each year get uremia. In our country, the number of end-stage uremia who need hematodialysis or transplantation is1.3million, And is growing at a rate of200to300thousand people a year. Renal transplantation is one of the main methods for the treatment of uremia. Relative to the hemodialysis and peritoneal dialysis, it can improve life quality and prolong survival time in patients. Due to the serious lack of cadaveric donor kidney, the lack of domestic brain death legislation, cardiac death organ donation(DCD)just beginning, renal source cannot meet the clinical need. The percentage of relatives living donor kidney transplantation in all transplantation is rising. With the progress of medical technologye, retroperitoneoscopy living donor nephrectomy(RPLDN) has become main method. The surgical method is effective to reduce bleeding and protect the renal. To assess the clinical value of retroperitoneal laparoseopic living donor nephrectomy (RPLDN) by comparing its clinical effects with open living donornephrectomy(ODN) and hand-assisted retroperitoneal laparoseopic living donor nephrectomy (HLDN)Objective:To assess the clinical value of retroperitoneal laparoseopic living donor nephrectomy (RPLDN) by comparing its clinical effects with open living donornephrectomy(ODN) and hand-assisted retroperitoneal laparoseopic living donor nephrectomy (HLDN)Methods:162patients who underwent live donor nephrectomy from July2003to december2011in the Shandong provincial Qianfoshan hospital were entered this retrospective analysis. ODN were performed in82patients, that of HLDN is15, and o RPLDN were performed in the other65patients. We collected clinical data to estimate the clinical effect of RPLDN, including the operation time, ischamia time, intraoperative blood loss, postoperative hospital stay, complications, etc.Results:Three groups of surgical were performed successfully in all the patients without conversion to open surgery. The mean surgical time of RPLDN is obviously shorter than RPLDN and HLDN groups. The mean warm ischemia time of RPLDN and HLDN are longer than ODN. the mean blood loss, hospital stay of the donors and length of renal vessels of RPLDN and HLDN are shorter than ODN. The recipients had normal renal function in one weeks. No recipients showed delayed graft function, and No one graft was lost function.Conclusion:Compared with open living donor nephrectomy (ODN),The laparoseopic living donor nephrectomy(LDN), especially the retroperitoneal laparoseopic living donor nephrectomy (RPLDN), is an efficient way to get kidney in vivo, with the advantage of smallerTrauma, shorter surgical time, fewer complications and postoperative recovery.