Pure Laparoscopic Left Lateral Sectionectomy in Living Donors From Innovation to Development in France
Pure Laparoscopic Left Lateral Sectionectomy in Living Donors From Innovation to Development in France
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DOI：
10.1097/sla.0000000000000642
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发表时间：
2015-03-01
影响因子：
9
通讯作者：
Soubrane, Olivier
中科院分区：
文献类型：
--
作者：
Scatton, Olivier;Katsanos, Georgios;Soubrane, Olivier
目的：在这项研究中，我们报告了法国70名活体献血者的结果。背景：儿童活体肝移植左外侧切除术是一种标准化的手术方法。我们的团队于2002年引入腹腔镜方法进行活体捐赠，并于2006年讨论了该方法的可重复性和安全性。方法：在2001年3月至2012年10月期间，共有70名捐赠者接受了肝脏获取。67例（95.7%）供体行左侧肝切断术，3例行左肝切断术，未获得肝中静脉。所有数据前瞻性地记录在数据库中。结果：在70例供体中，66例（94%）的肝移植是通过腹腔镜完成的，而4例（6%）的患者需要转化为开放式技术。17例供者出现并发症，总并发症率为24.2%。根据Clavien系统，11名献血者（16%）有1级并发症。5名献血者（7.1%）出现2级并发症，1名献血者（1.4%）出现3级并发症。无人员死亡。总体而言，儿童受体的患者和移植物1年生存率分别为95%和92%，3年生存率分别为95%和88%，5年生存率分别为95%和84%。结论：在法国，用于活体供肝移植的腹腔镜左外侧切除术是安全且可重复的，已经从一项创新手术过渡到发展阶段。
Objective: In this study, we report the results obtained from 70 living donors in France.Background: Left lateral sectionectomy for pediatric live donor liver transplantation is a well-standardized surgical procedure. Our team introduced the laparoscopic approach to live donation in 2002, and the reproducibility and safety of this method was discussed in 2006.Methods: Between March 2001 and October 2012, a total of 70 donors underwent a liver procurement. Sixty-seven donors (95.7%) underwent a left lateral sectionectomy, and 3 underwent a left hepatectomy without middle hepatic vein procurement. All data were prospectively recorded in a database.Results: Of the 70 donors, 66 (94%) liver grafts were procured by laparoscopy, whereas 4(6%) patients required conversion into an open technique. Seventeen donors experienced complications, leading to an overall complication rate of 24.2%. Eleven donors (16%) had grade 1 complications, according to the Clavien system. Five donors (7.1%) presented grade 2 complications, and 1 donor (1.4%) had a grade 3 complication. No death occurred. Overall, patient and graft survival rates for pediatric recipients were 95% and 92% at 1 year, 95% and 88% at 3 years, and 95% and 84% at 5 years, respectively.Conclusions: The laparoscopic retrieval of the left lateral section for live donor liver transplantation is safe and reproducible and has transitioned from an innovative surgery to a development phase in France.