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目的总结肾离体手术在肾移植中的临床应用经验。方法 2002年2月至4月第四军医大学西京医院泌尿外科分别行离体肾肿瘤剜除术后自体肾移植1例和离体供肾输尿管镜下钬激光碎石清石术后亲属活体肾移植1例。分析2例受者临床资料并进行文献复习。结果病例1:离体手术中肿瘤完整剜除,病理检查切缘未见癌组织,自体肾移植手术顺利;随访7个月,血清肌酐、血尿素氮水平略高于正常,无需透析,无肿瘤复发及转移。病例2:输尿管镜下可见离体供肾内两枚直径分别为8和12mm的结石,均成功取出;肾移植术中留置输尿管支架;术后未见相关并发症,随访10个月,移植肾内未见结石复发。结论肾离体手术有助于减少手术损伤,最大限度地维护患者肾脏功能,减少等待肾移植人群。正确选择适应证至关重要。
Objective To summarize the clinical experience of renal transplantation in renal transplantation. Methods From January to April 2002, Xijing Hospital of the Fourth Military Medical University, Urology, respectively, autologous kidney transplantation in 1 case of excision of renal tumors and ex vivo renal ureteroscopic holmium laser lithotripsy after living relative to renal Transplantation in 1 case. The clinical data of 2 patients were analyzed and literature review was conducted. Results Case 1: Tumor was completely excised from the surgically removed tumor, and the tumor tissue was not margined on the pathological examination. The autologous renal transplantation was performed smoothly. Serum creatinine and blood urea nitrogen levels were slightly higher than normal at 7 months of follow-up, Recurrence and metastasis. Case 2: Ureteroscopy showed two renal calculi with diameters of 8 and 12 mm, respectively. Both of them were successfully removed. Ureteral stents were placed in renal transplantation. No complications were found after operation. After 10 months of follow-up, No recurrence of stones within. Conclusion In vitro surgery can help reduce the surgical injury, maximize the maintenance of renal function in patients and reduce waiting for kidney transplant recipients. The correct choice of indications is crucial.