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经验丰富的外科医生进行肾移植术后淋巴囊肿的转归:精心实施的手术及经验是否足以预防淋巴囊肿?

Lymphocele Outcomes After Renal Transplantations Performed by an Experienced Surgeon: Is Meticulously Performed Surgery and Experience Adequate to Prevent Lymphocele?

作者信息

Ay Nurettin, Alp Vahhac, Duymuş Recai, Çetin Sedat

机构信息

Transplantation Center/General Surgery, Diyrabakır Education and Research Hospital, Diyarbakir, Turkey.

Department of Radiology, Diyarbakir Training and Research Hospital, Diyarbakir, Turkey.

出版信息

Ann Transplant. 2024 Feb 20;29:e942656. doi: 10.12659/AOT.942656.

Abstract

BACKGROUND The purpose of the present study was to analyze the rate of lymphoceles in kidney transplant operations meticulously performed by the same senior surgeon. MATERIAL AND METHODS The present study included 315 patients who were operated on in our organ transplantation center and followed up in the polyclinic after July 2013. The patients were retrospectively divided into 2 groups: patients with and without lymphocele. Symptomatic lymphocele (SL) has been defined as symptomatic fluid collection around the graft that necessitates an intervention for the graft or patient. RESULTS Lymphocele was observed in 82 (26%) patients. An intervention was needed in 16 (5.1%) of these cases. Demographic data such as age and sex of both groups were similar. Lymphocele cases were mostly asymptomatic, with a size <6 cm (75.6%). However, intervention was needed in 16 (75%) of the patients with a size ≥6 cm that were symptomatic. The length of time on dialysis in the pretansplant period was shorter in the group that developed lymphocele, and a lower rate of graft loss was observed in these patients. No statistically significant difference was found between the 2 groups in terms of rejection rates, serum albumin/globulin levels, and development of de novo DSA. CONCLUSIONS The risk factors reported in the literature related with lymphocele formation were not found to be statistically significant in our study. Complications, except lymphocele, were observed less frequently, but lymphocele formation was encountered in our patients despite meticulous surgery.

摘要

背景 本研究的目的是分析由同一位资深外科医生精心实施的肾移植手术中淋巴囊肿的发生率。

材料与方法 本研究纳入了2013年7月以后在我们器官移植中心接受手术并在门诊随访的315例患者。患者被回顾性地分为两组:有淋巴囊肿组和无淋巴囊肿组。有症状的淋巴囊肿(SL)被定义为移植肾周围有症状的液体积聚,需要对移植肾或患者进行干预。

结果 82例(26%)患者观察到淋巴囊肿。其中16例(5.1%)需要进行干预。两组的年龄和性别等人口统计学数据相似。淋巴囊肿病例大多无症状,大小<6 cm(75.6%)。然而,大小≥6 cm且有症状的患者中有16例(75%)需要进行干预。发生淋巴囊肿的组术前透析时间较短,这些患者的移植肾丢失率较低。两组在排斥反应率、血清白蛋白/球蛋白水平和新发供者特异性抗体(DSA)的发生方面未发现统计学显著差异。

结论 在我们的研究中,未发现文献报道的与淋巴囊肿形成相关的危险因素具有统计学显著性。除淋巴囊肿外的并发症观察到的频率较低,但尽管手术操作精细,我们的患者中仍出现了淋巴囊肿形成。

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本文引用的文献

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Lymphocele in Kidney Transplantation: A Comparison of Ligation and Non-ligation Technique of Iliac Lymphatic Dissection.
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Treatment of the Lymphocele After Kidney Transplantation: A Single-center Experience.
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