Peluso Gaia, Incollingo Paola, Campanile Silvia, Menkulazi Marsela, Scotti Alessandro, Tammaro Vincenzo, Calogero Armando, Dodaro Concetta, Carlomagno Nicola, Santangelo Michele L
Operative Unit of General Surgery and Kidney Transplantation - Advanced Biomedical Science Department - University Federico II of Naples, Naples, Italy.
Operative Unit of General Surgery and Kidney Transplantation - Advanced Biomedical Science Department - University Federico II of Naples, Naples, Italy.
Transplant Proc. 2020 Jun;52(5):1562-1565. doi: 10.1016/j.transproceed.2020.02.053. Epub 2020 Apr 14.
Wound complication frequently arises after kidney transplantation and its risk factors are well known. In a previous paper we analyzed these factors, and in this new retrospective study we evaluate the influence of lymphocele in the development of wound complications.
From January 2000 to December 2018, 731 consecutive kidney transplants have been performed in our center. We have analyzed the incidence of wound complication and lymphocele and their risk factors.
Out of 731 kidney transplants, we have observed wound complications in 115 patients (15.7%) and lymphocele in 158 patients (21.7%). Of these, 70 patients developed both complications (9.5%), but 6 patients have been excluded because they were in therapy with mammalian target of rapamycin inhibitors. Twenty-nine patients (45.3%) presented a first level and 35 patients (54.7%) showed second level wound complications. Lymphocele was the only present factor in just 3 cases (4.6%). The other patients showed diabetes in 28 cases (43.7%), overweight/obesity in 38 (59.3%), delayed graft function in 17 (26.5%), and 60 years or more in 38 (57.8%). The association has been found in 30 out 64 patients treated with tacrolimus (46.8%) and in 34 with cyclosporine (53.1%); 40 patients did not receive muscular layer's reconstruction (62.5%).
Our experience shows that lymphocele alone is not a predisposing factor for wound dehiscence after kidney transplantation, and they often coexist because they share the same risk factors, the most important being obesity, diabetes and delayed graft function, older age, and surgical techniques. No relation has been observed with calcineurin inhibitor therapy.
肾移植术后伤口并发症经常出现,其危险因素已为人熟知。在之前的一篇论文中我们分析了这些因素,在这项新的回顾性研究中,我们评估淋巴囊肿对伤口并发症发生的影响。
2000年1月至2018年12月,我们中心连续进行了731例肾移植手术。我们分析了伤口并发症和淋巴囊肿的发生率及其危险因素。
在731例肾移植患者中,我们观察到115例(15.7%)出现伤口并发症,158例(21.7%)出现淋巴囊肿。其中,70例患者同时出现这两种并发症(9.5%),但6例患者因正在接受雷帕霉素靶蛋白抑制剂治疗而被排除。29例患者(45.3%)出现一级伤口并发症,35例患者(54.7%)出现二级伤口并发症。仅有3例(4.6%)患者的唯一现存因素是淋巴囊肿。其他患者中,28例(43.7%)患有糖尿病,38例(59.3%)超重/肥胖,17例(26.5%)移植肾功能延迟,38例(57.8%)年龄在60岁及以上。在接受他克莫司治疗的64例患者中有30例(46.8%)存在这种关联,在接受环孢素治疗的34例患者中有34例(53.1%)存在这种关联;40例患者未进行肌层重建(62.5%)。
我们的经验表明,单独的淋巴囊肿不是肾移植术后伤口裂开的诱发因素,它们经常共存是因为有相同的危险因素,其中最重要的是肥胖、糖尿病、移植肾功能延迟、高龄以及手术技术。未观察到与钙调神经磷酸酶抑制剂治疗有关。