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采用肾移植后放置引流管策略评估持续性淋巴液渗漏:一项评估其来源的统计分析

Evaluation of Persistent Lymphatic Fluid Leakage Using a Strategy of Placing a Drain After Kidney Transplantation: A Statistical Analysis to Assess Its Origin.

作者信息

Inoue T, Saito M, Narita S, Numakura K, Tsuruta H, Maeno A, Tsuchiya N, Satoh S, Habuchi T

机构信息

Department of Urology, Akita University Graduate School of Medicine, Akita, Japan.

Department of Urology, Akita University Graduate School of Medicine, Akita, Japan.

出版信息

Transplant Proc. 2017 Oct;49(8):1786-1790. doi: 10.1016/j.transproceed.2017.06.021.

Abstract

OBJECTIVES

Using a strategy of placing a surgical drain after kidney transplantation, the duration of a lymphatic fluid leakage and prevalence of a symptomatic lymphocele were retrospectively analyzed. The risk factors for persistent lymphatic fluid leakage or asymptomatic lymphocele were evaluated using multivariate analysis to estimate the origin of the lymphatic fluid leakage.

MATERIALS AND METHODS

Patients with persistent lymphatic fluid leakage and symptomatic lymphocele were defined as those with lymphatic fluid drainage >50 mL for more than 15 days and those who required a percutaneous drainage of the lymphocele, respectively.

RESULTS

Persistent lymphatic fluid leakage and symptomatic lymphocele were observed in 40 (16.4%) and 10 (4.1%) of a total of 244 patients, respectively. The maximum durations of lymphatic fluid drainage from the initial drain tube and the second drainage of the symptomatic lymphocele were 48 and 28 days, respectively. Anastomosis of the graft artery to the external iliac artery was an independent risk factor to predict persistent lymphatic fluid leakage or symptomatic lymphocele after kidney transplantation (odds = 2.597, P = .008).

CONCLUSION

The findings of the study suggest that the lymphatic fluid originates from the recipient's iliac lymph trunk rather than from the graft kidney.

摘要

目的

采用肾移植术后放置外科引流管的策略,回顾性分析淋巴液漏出的持续时间及有症状淋巴囊肿的发生率。使用多因素分析评估持续性淋巴液漏出或无症状淋巴囊肿的危险因素,以估计淋巴液漏出的来源。

材料与方法

持续性淋巴液漏出患者和有症状淋巴囊肿患者分别定义为淋巴液引流量>50 mL持续超过15天的患者和需要经皮引流淋巴囊肿的患者。

结果

在总共244例患者中,分别有40例(16.4%)出现持续性淋巴液漏出,10例(4.1%)出现有症状淋巴囊肿。从初始引流管引流淋巴液的最长持续时间和有症状淋巴囊肿的二次引流最长持续时间分别为48天和28天。移植肾动脉与髂外动脉的吻合是预测肾移植术后持续性淋巴液漏出或有症状淋巴囊肿的独立危险因素(比值=2.597,P = .008)。

结论

该研究结果表明,淋巴液起源于受者的髂淋巴干而非移植肾。

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