Comparison of Three Alternatives for Living Donor Nephrectomy
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概要
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Background. We re-started living kidney transplant in June 2006 after 20 years of interval at Hirosaki University Hospital. We sequentially changed procedure of living donor nephrectomy. First, donor nephrectomy was carried out by open surgery with a small incision （10 cm）. We then introduced laparoscopic retroperitoneal approach followed by laparoscopic intraperitoneal approach. Here, operative and clinical outcome of the three alternatives of donor nephrectomy was evaluated.Methods. Twenty-seven cases who underwent living donor nephrectomy between June 2006 and July 2011 at Hirosaki University Hospital were enrolled. There were 12 males and 15 females with a mean age of 54.3 years. We performed 7 open donor nephrectomy with a small incision, 5 laparoscopic retroperitoneal donor nephrectomy, and 15 laparoscopic intraperitoneal donor nephrectomy.Results. Operation time was 155 min., 250 min., and 214 min., respectively. Estimated blood loss was 310 g, 100g, and 95g, respectively. Warm ischemic time was 2.0 min., 3.0 min., and 3.0 min., respectively. Patients who underwent laparoscopic donor nephrectomy cloud start to walk significantly earlier than those who underwent open donor nephrectomy. There were no surgical complications, nor conversion to open donor nephrectomy from laparoscopic donor nephrectomy. There were no significant difference with post-operative serum creatinine concentration in the donors among the three operation procedures.Conclusions. Safety procedure is the most important for living donor nephrectomy. Laparoscopic donor nephrectomy is safe and associated with early recovery of the donors. Longer and careful observation is necessary for renal function of the donors.
- 2013-00-00
著者
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Yoneyama Tohru
Department Of Physics Faculty Of Science Shizuoka University
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Suzuki Yuichiro
Department Of Biology Duke University
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Koie Takuya
Department Of Hygiene Hirosaki University School Of Medicine
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Yoneyama Takahiro
Department Of Urology Hirosaki University Graduate School Of Medicine
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Kamimura Noritaka
Department Of Physiology Hirosaki University School Of Medicine
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Ohyama Chikara
Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine
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Hatakeyama Shingo
Department of Advanced Transplant and Regenerative Medicine, Graduate School of Medicine, Hirosaki University
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Kudo Shigemasa
Department of Urology, Hirosaki University Graduate School of Medicine
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Okamoto Teppei
Department of Urology, Hirosaki Graduate School of Medicine
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Kamimura Noritaka
Department of Urology, Hirosaki Graduate School of Medicine
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Ishibashi Yusuke
Department of Urology, Hirosaki Graduate School of Medicine
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Tobisawa Yuki
Department of Urology, Hirosaki Graduate School of Medicine
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Kudo Shigemasa
Department of Urology, Hirosaki Graduate School of Medicine
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Yoneyama Tohru
Department of Advanced Transplantation & Regenerative Medicine, Hirosaki University Graduate School of Medicine
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Yoneyama Takahiro
Department of Urology, Hirosaki Graduate School of Medicine
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