Wang Junxiang, Zhao Lixiang, Feng Guiwen, Shang Wenjun
The Department of Kidney Transplantation, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Front Pediatr. 2022 Apr 6;10:862552. doi: 10.3389/fped.2022.862552. eCollection 2022.
Recently, the demand for minimally invasive techniques in kidney transplantation (MIKT) has increased. However, there is only a limited number of studies on MIKT, especially in pediatric kidney transplants. Hence, we evaluated whether there is a difference between the super-minimal incision technique in pediatric kidney transplantation (SMIPKT) and conventional kidney transplantation (CKT).
Between December 2018 and November 2021, 34 patients who underwent pediatric kidney transplantation with a follow-up of 1 month were enrolled. A paired kidney analysis was performed to minimize donor variability and bias. The SMIPKT and CKT groups included 17 patients.
There was no difference in baseline clinical characteristics, including age, sex, the donor/ recipient weight ratio (DRWR), choice of dialysis modality, pretransplant dialysis time, BMI, renal artery number, cause of ESRD, DGF, length of the kidney and cold ischemic time, tacrolimus concentration at 3 and 7 days, serum creatinine at 1 month and postoperative complication rate between the SMIPKT and CKT groups (all > 0.05). However, the length of the incision, operation time, intraoperative bleeding, postoperative drainage volume within 24 h and Vancouver scar scale at 1 month were statistically significant (all < 0.05).
Compared with CKT, our results indicated that SMIPKT showed more satisfactory cosmetic results, shorter SMIPKT operating time, and reduced intraoperative bleeding and postoperative drainage volume within 24 h. There were also no statistical differences in postoperative complications. Hence, we suggest that SMIPKT is an appropriate method for pediatric kidney transplantation.
近年来，肾移植微创技术（MIKT）的需求不断增加。然而，关于MIKT的研究数量有限，尤其是在小儿肾移植方面。因此，我们评估了小儿肾移植超微小切口技术（SMIPKT）与传统肾移植（CKT）之间是否存在差异。
2018年12月至2021年11月期间，纳入34例接受小儿肾移植且随访1个月的患者。进行配对肾脏分析以尽量减少供体变异性和偏差。SMIPKT组和CKT组各有17例患者。
SMIPKT组和CKT组在基线临床特征方面无差异，包括年龄、性别、供体/受体体重比（DRWR）、透析方式选择、移植前透析时间、BMI、肾动脉数量、终末期肾病病因、移植肾功能延迟恢复（DGF）、肾脏长度和冷缺血时间、术后3天和7天的他克莫司浓度、术后1个月的血清肌酐以及术后并发症发生率（均>0.05）。然而，切口长度、手术时间、术中出血、术后24小时内引流量和术后1个月的温哥华瘢痕量表评分差异有统计学意义（均<0.05）。
与CKT相比，我们的结果表明SMIPKT具有更满意的美容效果、更短的手术时间，并减少了术中出血和术后24小时内的引流量。术后并发症方面也无统计学差异。因此，我们认为SMIPKT是小儿肾移植的一种合适方法。
