Division of Transplantation, Hiram C. Polk Jr. MD Department of Surgery, University of Louisville, Louisville, KY. 550 South Jackson Street, Department of Surgery, Louisville, KY, 40202, USA.
Division of Transplantation, Hiram C. Polk Jr. MD Department of Surgery, University of Louisville, Louisville, KY. 550 South Jackson Street, Department of Surgery, Louisville, KY, 40202, USA.
Am J Surg. 2019 Jul;218(1):27-31. doi: 10.1016/j.amjsurg.2019.01.018. Epub 2019 Jan 24.
This study was undertaken to characterize unplanned return to the OR following kidney transplantation(KT).
All patients undergoing KT at a single center from 1/2015 through 11/2017 were evaluated. The primary endpoint was unplanned return to the OR within 90 days. Perioperative and one year patient and graft outcomes were also determined.
Of 190 patients, 14(7.4%) of patients had unplanned reoperation. The most common individual indications were bleeding from biopsy sites(n = 2), poor vascular flow on postop ultrasound(n = 4), and perforated diverticulitis(n = 2). Forty Three percent of all reoperations were unrelated to the technical conduct of the transplant operation. Reoperated patients had significantly worse survival at one year(78.6% vs. 96.6%), although graft function in survivors was similar to those who did not return to the OR.
Reoperation following KT is frequently unrelated to the technical conduct of the transplant procedure, thus it may not be useful as a quality metric.
本研究旨在描述肾移植（KT）后计划外返回手术室的情况。
评估了 2015 年 1 月至 2017 年 11 月在单一中心接受 KT 的所有患者。主要终点是 90 天内计划外返回手术室。还确定了围手术期和一年的患者和移植物的结果。
在 190 名患者中，有 14 名（7.4%）患者进行了计划外再次手术。最常见的单个指征是活检部位出血（n=2）、术后超声显示血流不良（n=4）和憩室穿孔（n=2）。所有再手术中有 43%与移植手术的技术操作无关。再次手术的患者在一年时的生存率明显较低（78.6% vs. 96.6%），尽管幸存者的移植物功能与未返回手术室的患者相似。
KT 后再次手术通常与移植手术的技术操作无关，因此它可能不作为质量指标有用。
