自己血回収法にて無輸血で部分切除術を施行した腎外傷

A Case Report of Partial Nephrectomy Using Intraoperative Autologous Transfusion for Blunt Renal Trauma with No Allogeneic Transfusion

　症例は33歳，女性。早朝に部屋で高所より転落し右側腹部を打撲，腹部膨満と右腹痛を訴え受診した。CTにて右腎中極の断裂を認め，右腎部分切除術を行った。肋骨弓下横切開にて腹腔内に入り，大動静脈および右腎動脈を確保し，全阻血時間60分で断裂した右腎下極を切除した。術野より自己血回収輸血を行い，周術期を含めて同種血輸血を行わなかった。術後合併症を認めず，残存腎機能は良好である。

A 33-year-old woman with right traumatic renal perfora-tion underwent right partial nephrectomy using intraopera-tive autologous transfusion with no allogenic transfusion. Following transverse skin incision abdominal aorta and right renal vessels were exposed transperitonically. Sys-temic heparinization (1.0 mg/kg) was performed after clamping of right renal vessels. Right lower pole of perfo-rated kidney was removed within total ischemic time (60 minutes) . Intraoperative blood loss was 1270ml and 300ml of which was returned as autologus blood.