Lo Monte Attilio Ignazio, Damiano Giuseppe, Palumbo Vincenzo Davide, Spinelli Gabriele, Buscemi Giuseppe
Department of Surgical, Oncological, and Stomatological Disciplines, University of Palermo, Palermo, Italy.
Artif Organs. 2015 Oct;39(10):916-21. doi: 10.1111/aor.12467. Epub 2015 Apr 20.
Automatic vascular staplers for vascular anastomoses in kidney transplantation may dramatically reduce the operative time and, in particular, warm ischemia time, thus increasing the outcome of transplantation. Ten pigs underwent kidney auto-transplantation by automatic anastomotic device. Kidneys were collected by laparotomy with selective ligations at the renal hilum and perfused with cold storage solution. To overcome the shortage in length of renal hilum, a tract of the internal jugular vein was harvested to increase the length of the vessels. The anastomoses were totally performed by the use of the anastomotic device. On 10 kidney transplants, nine were successful and no complications occurred. Renal resistive indexes showed a slight increase in the immediate postoperative period returning normal at 10 days of follow-up. We demonstrated the possibility to perform renal vascular anastomoses by means of an automatic anastomotic device. This instrument developed for coronary bypass surgery by virtue of the small caliber of the vessels could be adopted on a larger scale for renal transplantation. The reduced warm ischemia time needed for anastomosis may help to achieve a better outcome for the graft and expand the pool of marginal donors in renal transplantation.
用于肾移植血管吻合的自动血管吻合器可显著缩短手术时间，尤其是热缺血时间，从而提高移植效果。十头猪通过自动吻合装置进行了肾脏自体移植。通过剖腹术收集肾脏，在肾门处进行选择性结扎，并用冷保存液灌注。为克服肾门长度不足的问题，截取一段颈内静脉以增加血管长度。吻合完全通过使用吻合装置完成。在10例肾脏移植中，9例成功，未发生并发症。肾阻力指数在术后即刻略有升高，随访10天时恢复正常。我们证明了通过自动吻合装置进行肾血管吻合的可能性。这种为冠状动脉搭桥手术开发的器械，由于血管口径小，可在肾移植中更广泛地应用。吻合所需的热缺血时间缩短可能有助于提高移植物的效果，并扩大肾移植中边缘供体的范围。
