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纤维蛋白胶作为无支架腹腔镜肾盂成形术的密封剂:一项随机对照试验。

Fibrin glue as a sealant in stentless laparoscopic pyeloplasty: A randomised controlled trial.

作者信息

Farouk Ahmed, Tawfick Ahmed, Reda Mahmoud, Saafan Ahmed M, Mousa Waleed, Tawfeek Ahmed M, Shaker Hassan

机构信息

Department of Urology, Ain Shams University Hospitals, Cairo, Egypt.

出版信息

Arab J Urol. 2019 May 9;17(3):228-233. doi: 10.1080/2090598X.2019.1611990. eCollection 2019.

Abstract

: To evaluate the value of adding fibrin glue, as a sealant material, to the anastomotic line during stentless laparoscopic pyeloplasty (LPP). : In all, 92 patients with pelvi-ureteric junction obstruction (PUJO), scheduled for LPP, were randomised into two groups (46 in each group). Group A, underwent transperitoneal stentless LLP sealed with fibrin glue, whilst Group B underwent the same procedure without fibrin glue. : Both groups were similar for patient demographics and presentation. Despite that, we found a significant statistical difference between the groups for operative time and blood loss. The total number of patients that had a urinary leak was 10 and 24 patients, in groups A and B respectively ( = 0.002). A prolonged leak lasting for >5 days, which stopped spontaneously occurred in three patients (7.14%) in Group A and six (14.3%) in Group B ( = 0.265). A persistent 14-day leak that needed intervention developed in two patients (4.3%) in Group A and five (10.9%) in Group B ( = 0.434). One patient in Group B developed urinoma 1 week after discharge, and another patient in the same group developed deep venous thrombosis. There was no significant difference between the groups for postoperative complications in the early 3-month period. The success rate was 39 (92.86%) and 36 patients (85.7%), in groups A and B respectively ( = 0.265). : Adding fibrin glue to seal the anastomosis decreased urinary leakage but did not have a significant impact on outcomes. : CONSORT: Consolidated Standards of Reporting Trials; DTPA: diethylene-triamine-penta-acetic acid; LPP: laparoscopic pyeloplasty; PUJO: PUJ obstruction; T½: clearance halftime (renogram).

摘要

评估在无支架腹腔镜肾盂成形术(LPP)中,于吻合口处添加纤维蛋白胶作为密封材料的价值。

总共92例计划行LPP的肾盂输尿管连接部梗阻(PUJO)患者被随机分为两组(每组46例)。A组接受经腹无支架LPP并用纤维蛋白胶密封,而B组接受相同手术但未使用纤维蛋白胶。

两组患者的人口统计学特征和临床表现相似。尽管如此,我们发现两组在手术时间和失血量方面存在显著统计学差异。A组和B组分别有10例和24例患者发生尿漏(P = 0.002)。A组有3例患者(7.14%)出现持续>5天的长时间漏尿且自行停止,B组有6例(14.3%)(P = 0.265)。A组有2例患者(4.3%)出现持续14天且需要干预的漏尿,B组有5例(10.9%)(P = 0.434)。B组有1例患者在出院1周后发生尿囊肿,同一组的另1例患者发生深静脉血栓形成。两组在术后3个月早期的并发症方面无显著差异。A组和B组的成功率分别为39例(92.86%)和36例(85.7%)(P = 0.265)。

添加纤维蛋白胶密封吻合口可减少尿漏,但对结局无显著影响。

CONSORT

试验报告的统一标准;DTPA:二乙三胺五乙酸;LPP:腹腔镜肾盂成形术;PUJO:肾盂输尿管连接部梗阻;T½:清除半衰期(肾图)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea59/6711147/89cb94402d11/TAJU_A_1611990_F0001_C.jpg

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