Costa H F, Malvezzi Messias P, dos Reis F P, Gomes-Junior O, Fernandes L M, Abdalla L G, Campos S V, Teixeira R H O B, Samano M N, Pêgo-Fernandes P M
Thoracic Surgery Division of Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Thoracic Surgery Division of Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Transplant Proc. 2017 May;49(4):878-881. doi: 10.1016/j.transproceed.2017.03.002.
Surgical and nonsurgical abdominal complications have been described after lung transplantation. However, there is limited data on this event in this population. The objective of this study was to analyze the incidence of abdominal complications in patients undergoing lung transplantation at the Heart Institute of the Faculty of Medicine, University of São Paulo (InCor-HCFMUSP) between the years 2003 and 2016. The main causes of abdominal complications were inflammatory acute abdomen (7 patients; 14%), obstructive acute abdomen (9 patients; 18%), gastroparesis (4 patients; 8%), distal intestinal obstruction syndrome (4 patients; 8%), perforated acute abdomen (7 patients; 14%), cytomegalovirus (CMV; 6 patients; 12%), and other reasons (12 patients; 26%). Separating these patients according to Clavien-Dindo classification, we had 21 patients (43%) with complications grade II, 4 patients (8%) with complications grade IIIa, 7 patients (14%) with grade IIIb complications, 7 patients (14%) with grade IV complications, and 10 patients (21%) with grade complications V. In conclusion, abdominal disorders are seriously increased after lung transplantation and correlate with a high mortality. Early abdominal surgical complication has worse prognosis.
肺移植术后的外科及非外科腹部并发症已有相关报道。然而,关于这一人群中此类事件的数据有限。本研究的目的是分析2003年至2016年间在圣保罗大学医学院心脏研究所(InCor-HCFMUSP)接受肺移植的患者腹部并发症的发生率。腹部并发症的主要原因包括炎症性急腹症(7例;14%)、梗阻性急腹症(9例;18%)、胃轻瘫(4例;8%)、远端肠梗阻综合征(4例;8%)、穿孔性急腹症(7例;14%)、巨细胞病毒(CMV;6例;12%)及其他原因(12例;26%)。根据Clavien-Dindo分类对这些患者进行划分,我们发现有21例(43%)患者出现II级并发症,4例(8%)患者出现IIIa级并发症,7例(14%)患者出现IIIb级并发症,7例(14%)患者出现IV级并发症,10例(21%)患者出现V级并发症。总之,肺移植术后腹部疾病显著增加,且与高死亡率相关。早期腹部外科并发症的预后较差。