Department of Surgery, Reina Sofia University Hospital, Avda. Menéndez Pidal s/n, 14004, Cordoba, Spain.
World J Surg. 2010 Dec;34(12):2991-6. doi: 10.1007/s00268-010-0774-z.
The purpose of the study was to analyze the incidence of intra-abdominal infectious complications after the application of a fibrinogen sealant to the duodenojejunal anastomosis in simultaneous pancreas-kidney transplants (SPK) with enteric drainage.
Results of 68 SPKs with enteric drainage were prospectively assessed. A fibrinogen and thrombin sheet was applied to the duodenojejunal anastomosis in 34 patients, who were compared to a control group of 34 patients. The incidence and severity of intra-abdominal infectious complications and the 1-year patient and grafts survival were analyzed.
Eighteen patients experienced intra-abdominal infectious complications. Grade 1a complications occurred in the study group, whereas surgery was required only in patients from the control group: complications grade 3a (15%) and complications grade 3b (18%) (p = 0.003 vs. study group, respectively). The overall rate of anastomotic leakage (complications grade 2b and 3b) was 10%, all of which occurred in the control group. The length of hospital stay was higher in the control group was 34.6 ± 11.3 days vs. 22.8 ± 11.1 days (p = 0.03). There were no significant differences in 1-year patient and graft survival between groups.
In our study, the application of fibrinogen and thrombin sheets was associated to a decrease in the number and severity of intra-abdominal infectious complications.
本研究旨在分析在伴有肠引流的胰肾联合移植（SPK）中应用纤维蛋白原密封剂封闭十二指肠空肠吻合口后，发生腹腔内感染性并发症的发生率。
前瞻性评估 68 例伴有肠引流的 SPK 的结果。34 例患者应用纤维蛋白原和凝血酶片封闭十二指肠空肠吻合口，与 34 例对照组患者进行比较。分析腹腔内感染性并发症的发生率和严重程度，以及 1 年患者和移植物存活率。
18 例患者发生腹腔内感染性并发症。研究组发生 1a 级并发症，而对照组则需要手术治疗：3a 级（15%）和 3b 级（18%）并发症（分别为 p=0.003）。吻合口漏（2b 级和 3b 级并发症）的总发生率为 10%，均发生在对照组。对照组的住院时间较长，为 34.6±11.3 天，而研究组为 22.8±11.1 天（p=0.03）。两组患者的 1 年生存率和移植物存活率无显著差异。
在本研究中，应用纤维蛋白原和凝血酶片可减少腹腔内感染性并发症的数量和严重程度。
