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单中心采用多种血管吻合技术的活体供肾移植的序贯分析。

Sequential analysis of single-center experience of living donor kidney transplants with several vascular anastomosis techniques.

机构信息

Department of General Surgery, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul, Turkey

Department of General Surgery, Faculty of Medicine, İstinye University Liv Hospital, İstanbul, Turkey

出版信息

Turk J Med Sci. 2021 Jun 28;51(3):1439-1447. doi: 10.3906/sag-2007-285.

Abstract

BACKGROUND AND AIM

Vascular variations of grafts are handled with various reconstruction techniques in renal transplantation. We aimed to analyze the effects of these reconstruction techniques and sites on patient/graft outcomes.

MATERIALS AND METHODS

Renal transplantation cases at the Transplantation Unit of the General Surgery Department, İstanbul Uni- versity Cerrahpaşa Medical Faculty between January 1st, 2000 and December 31st, 2012 were analyzed retrospectively. Postoperative duplex ultrasound results, urea-creatinine reduction rates, and complications were evaluated.

RESULTS

There were 228 living-donor transplantation cases evaluated. For single-renal-artery living-donor transplantations, there were 45 end-to-side external iliac artery, 15 end-to-side internal iliac artery, 152 end-to-end internal iliac artery, and 3 end-to-side common iliac artery anastomoses performed. In cases with double-arteries, 3 had end-to-side external iliac artery anastomoses, and 10 had end- to-end internal iliac artery anastomoses. No statistically significant differences were found between reconstruction techniques with regard to complications or urea-creatinine reduction rates.

CONCLUSION

Internal, external, and common iliac arteries can be safely used for anastomoses. The presence of more than one renal artery creates no short or long-term problems when a side-to-side anastomosis is initially performed.

摘要

背景与目的

在肾移植中,采用各种重建技术来处理移植物的血管变异。我们旨在分析这些重建技术和部位对患者/移植物结局的影响。

材料与方法

回顾性分析了 2000 年 1 月 1 日至 2012 年 12 月 31 日期间在伊斯坦布尔大学 Cerrahpaşa 医学系普外科移植科进行的肾移植病例。评估了术后双功能超声检查结果、尿素-肌酐降低率和并发症。

结果

共评估了 228 例活体供肾移植病例。对于单肾动脉活体供肾移植,进行了 45 例外髂动脉端侧吻合、15 例内髂动脉端侧吻合、152 例内髂动脉端端吻合和 3 例髂总动脉端侧吻合。对于双动脉病例,有 3 例进行了外髂动脉端侧吻合,10 例进行了内髂动脉端端吻合。在并发症或尿素-肌酐降低率方面,不同的重建技术之间没有统计学差异。

结论

内、外和髂总动脉均可安全用于吻合。当最初进行侧侧吻合时,存在多条肾动脉不会造成短期或长期问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5722/8283428/3f7c98a713b6/turkjmedsci-51-1439-fig001a.jpg

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