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[转帖]【消息】美完成一例特殊肾脏移植手术 从阴道取肾
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[转帖]【消息】美完成一例特殊肾脏移植手术 从阴道取肾 
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美国媒体2月2日报道，美国约翰斯·霍普金斯大学医学院医生完成了一例特殊肾脏移植手术。他们通过捐献者阴道取出肾脏。医生认为，这类摘除手术可减少捐献者疼痛、减小疤痕面积、缩短康复时间。 美联社说，这名捐献者是48岁的金伯莉·约翰逊，获捐者为她23岁的侄女珍妮·吉尔伯特。她们1月29日完成肾脏移植手术，约翰逊捐献的肾脏通过阴道取出。两人眼下状态良好。 约翰斯·霍普金斯大学医学院负责此次手术的医生罗伯特·蒙哥马利说，为避免肾脏通过阴道时受到细菌感染，医生先在约翰逊腹腔上切开一个小口，把一个塑料袋放入她的体内，保护捐献的肾脏。 “比生孩子容易” 手术只在约翰逊腹部留下3个豌豆大小的疤痕，其中一个疤痕藏在肚脐里。 蒙哥马利说，与开刀相比，通过阴道取肾可减少病人疼痛和康复时间。“估计约翰逊一两周内就能正常活动，相比之下，开刀手术需要几周时间”。育有3个孩子的约翰逊说，手术当晚她就能下床，“这比生孩子容易”。 约翰斯·霍普金斯大学方面认为，通过阴道取出功能健全的肾脏可能属世界首例。他们希望，通过阴道取肾能为肾脏移植手术带来便利，鼓励更多女性捐献肾脏。 阴道取肾手术过程 1. 在阴道取肾手术中，医生会先透过腹腔镜将肾脏割下。 2. 从腹腔切口放入连有绳子的胶袋，再将肾脏放入袋中。 3. 将装有肾脏的胶袋从阴道拉出体外。 Md. surgeons remove donated kidney through vagina BALTIMORE (AP) -- Surgeons removed a woman's kidney through her vagina so she could give it to her ailing niece, an unusual operation they hope will encourage others to donate because it reduces pain, scarring and recovery time. Doctors at Johns Hopkins University School of Medicine said donor Kimberly Johnson, 48, and her niece, Jennifer Gilbert, 23, were both doing well following operations Thursday. "It was easier than childbirth," said Johnson, who has three children. Transvaginal kidney removals have been done before to remove cancerous or nonfunctioning kidneys, and other diseased organs have also been removed through mouths and other orifices. Many donated kidneys are removed laparoscopically, through small keyhole incisions. But hospital officials think this may be the first time a donor kidney was removed through the vagina. The operation left three pea-size scars on the Lexington Park woman's abdomen, one hidden in her navel. Surgeons hope the procedure will lead more women to become donors, said Dr. Robert Montgomery, chief of the transplant division at Johns Hopkins, who led the team that performed the surgery. Johnson said the operation was less painful than gall bladder surgery and she is recovering more quickly than Gilbert's father, who gave his daughter a kidney 12 years ago. Gilbert, of Baltimore, needed the first transplant because repeated infections had destroyed the kidneys she was born with. She needed the second after she began suffering chronic rejection. Johnson, an assistant sales manager for a St. Mary's County newspaper, said she was able to get out of bed Thursday night, the same day the kidney was removed. Quicker recovery and less pain are the key benefits of the new technique, said Montgomery and Dr. Anthony Kalloo, the director of the Division of Gastroenterology at Johns Hopkins and a pioneer of the method of using natural orifices for organ removal. Kalloo said more than 300 such surgeries have been performed worldwide, mostly gall bladder and appendix removal through the mouth, anus and vagina. Kalloo said there has been some resistance in the medical community because of concerns, for example, that stomach acid could leak into the abdominal cavity in operations where organs were removed through the mouth. Dr. Jihad Kaouk, a urologist and director of the Cleveland Clinic's Center for Laparoscopic and Robotic Surgery, is among those concerned about contamination. He was not involved in Johnson's surgery. "There is the risk of infection having the kidney passing through a contaminated area and then going to another patient who is immunocompromised," Kaouk said. "That is the concern we have and we would like to monitor the outcome in that regard." In Johnson's case, Montgomery said a plastic bag placed into her abdominal cavity through a tiny incision protected the donated kidney from contamination by bacteria and other organisms in her vagina. Johnson was chosen because she has had a hysterectomy, which made the operation easier, but the procedure could be used without affecting women's ability to give birth, he said. More than 78,000 people are on the national waiting list to receive kidneys from deceased donors. The need is increasing as diabetes and obesity rise, threatening to further lengthen a wait that can last years. In 2007, more than a third of the 16,629 kidneys transplanted in the U.S. came from living donors, according to the United Network for Organ Sharing. Montgomery said the number of living donor transplants has tripled since laparoscopic removal debuted in 1995, providing an alternative to so-called "shark bite" abdominal incisions. He hopes advances such as the vaginal removal will continue the increase. "We think she'll be probably back to her normal activities within a week or two," the transplant surgeon said. Recovery from laproscopic surgery typically takes several weeks. "So, that greatly reduces the inconvenience of donating and we're hoping that will encourage more people to donate." |
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