Effect of pneumoperitoneum on renal function after robotic-assisted laparoscopic kidney transplantation
10.12464/j.issn.1674-7445.2024233
- VernacularTitle:气腹对机器人辅助腹腔镜下肾移植术后移植肾功能的影响
- Author:
Shuncheng TAN
1
;
Jianchun CUI
1
;
Xun SUN
1
;
Yongfeng LI
2
;
Yonglin SONG
1
;
Shuxin LI
1
;
Yinrui MA
1
;
Xingyong MA
1
;
Yafei ZHANG
1
Author Information
1. Department of Urology, the First People's Hospital of Kunming, Kunming 650011 , China.
2. .
- Publication Type:OriginalArticle
- Keywords:
Kidney transplantation;
Robotics;
Laparoscopy;
Pneumoperitoneum;
Serum creatinine;
Renal blood flow;
Carbon dioxide;
Complication
- From:
Organ Transplantation
2025;16(2):295-301
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of pneumoperitoneum pressure during robotic-assisted kidney transplantation (RAKT) on the function of the transplant kidney. Methods The data of 243 kidney transplant recipients were retrospectively analyzed and divided into open kidney transplantation (OKT) group (n=105) and RAKT group (n=138). The RAKT group was further divided into 13 mmHg group (n=67) and 7 mmHg group (n=71) based on pneumoperitoneum pressure. The donor information, recipient's preoperative general data, intraoperative data, and postoperative recovery of the three groups were compared. In the RAKT group, the renal artery, segmental artery, interlobar artery, and venous flow velocity of the transplant kidney were measured using laparoscopic ultrasound. Results There was a statistically significant difference in donor types among the groups (P<0.05), while other donor information and recipient's preoperative general data showed no statistically significant differences (all P>0.05). There were no statistically significant differences in serum creatinine and complications at 30 days and 1 year postoperatively among the groups (all P>0.05). The OKT group and 7 mmHg group had more intraoperative urine output than the 13 mmHg group. Both RAKT groups had less intraoperative blood loss and shorter hospital stays than the OKT group, and longer operation times than the OKT group (all P<0.05). There were no statistically significant differences in operation time, intraoperative blood loss, and hospital stay between the two RAKT groups (all P>0.05). The vascular flow velocity of the transplant kidney decreased at 13 mmHg compared to 7 mmHg pneumoperitoneum pressure, but the differences were not statistically significant (all P>0.05). Conclusions Controllable pneumoperitoneum pressure has a limited impact on the vascular flow velocity of the transplanted kidney. RAKT is a safe and effective surgical method under appropriate pneumoperitoneum pressure, and choosing a lower pneumoperitoneum pressure is more conducive to the early recovery of renal function postoperatively.
