Farouk Ahmed, Tawfick Ahmed, Reda Mahmoud, Saafan Ahmed M, Mousa Waleed, Tawfeek Ahmed M, Shaker Hassan
Department of Urology, Ain Shams University Hospitals, Cairo, Egypt.
Arab J Urol. 2019 May 9;17(3):228-233. doi: 10.1080/2090598X.2019.1611990. eCollection 2019.
: 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).
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。
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)