Kim Jiyoung, Lee Jeong-Moo, Yi Nam-Joon, Hong Suk Kyun, Choi YoungRok, Hong Kwangpyo, Han Eui Soo, Lee Kwang-Woong, Suh Kyung-Suk
Department of Surgery, Seoul National University Hospital, Seoul 08826, Korea.
J Clin Med. 2021 Apr 2;10(7):1462. doi: 10.3390/jcm10071462.
Large-for-size syndrome caused by organ size mismatch increases the risk of abdominal compartment syndrome. Massive transfusion and portal vein clamping during liver transplantation may cause abdominal compartment syndrome (ACS) related to mesenteric congestion. In general pediatric surgery-such as correcting gastroschisis-abdominal wall reconstruction for the reparation of defects using expanded polytetrafluoroethylene is an established method. The purpose of this study is to describe the ePTFE-Gore-Tex closure method in patients with or at a high risk of ACS among pediatric liver transplant patients and to investigate the long-term prognosis and outcomes.
From March 1988 to March 2018, 253 pediatric liver transplantation were performed in Seoul National University Hospital. We retrospectively reviewed the cases that underwent abdominal wall reconstruction with ePTFE during liver transplantation.
A total of 15 cases underwent abdominal closure with ePTFE-GoreTex graft. We usually used a 2 mm × 10 cm × 15 cm sized Gore-Tex graft for extending the abdominal cavity. The median follow up was 59.5 (17-128.7) months and there were no cases of ACS after transplantation. There were no infectious complications related to ePTFE implantation. The patient and graft survival rate during the study period was 93.3% (14/15).
Abdominal wall reconstruction using ePTFE is feasible and could be an alternative option for patients with a high risk of ACS.
器官大小不匹配导致的过大综合征会增加腹腔间隔室综合征的风险。肝移植期间大量输血和门静脉阻断可能会导致与肠系膜充血相关的腹腔间隔室综合征（ACS）。在一般小儿外科手术中，比如修复腹裂，使用膨体聚四氟乙烯进行腹壁重建以修复缺损是一种既定方法。本研究的目的是描述小儿肝移植患者中患有ACS或有ACS高风险患者的ePTFE-戈尔泰克闭合方法，并调查其长期预后和结果。
1988年3月至2018年3月，首尔国立大学医院进行了253例小儿肝移植手术。我们回顾性分析了肝移植期间使用ePTFE进行腹壁重建的病例。
共有15例患者使用ePTFE-戈尔泰克移植物进行腹壁闭合。我们通常使用2毫米×10厘米×15厘米大小的戈尔泰克移植物来扩大腹腔。中位随访时间为59.5（17 - 128.7）个月，移植后无ACS病例。没有与ePTFE植入相关的感染并发症。研究期间患者和移植物存活率为93.3%（14/15）。
使用ePTFE进行腹壁重建是可行的，对于有ACS高风险的患者可能是一种替代选择。
