Dongol Raj Man, Pahwa Mrinal, Adhikari Subarna, Adhikari Bindu
Department of Urology, Nepal Medical College Teaching Hospital, Kathmandu, Nepal.
Department of Urology and Kidney Transplant Surgery, Sir Ganga Ram Hospital, New Delhi, India.
Int Urol Nephrol. 2025 Mar;57(3):769-773. doi: 10.1007/s11255-024-04247-7. Epub 2024 Oct 26.
This study is to assess efficacy of fibrin sealant in vein anastomosis in renal transplantation in preventing blood loss and postoperative peri-graft collection.
This is a retrospective analytical case-control study of renal transplantations done in a tertiary care center in India in a 1-year period. Fibrin sealant was randomly used in vein anastomosis during the period. All the data were extracted and retrospectively analyzed. Those with fibrin sealant use were the study group and without sealant use were the control group. Primary objective was to assess effectiveness of fibrin sealant in preventing blood loss and postoperative peri-graft collection. Secondary objectives were to evaluate patients' demographic profile, hospital stay and other intraoperative and postoperative characteristics.
During the study, 163 patients were enrolled, 82 study group and 81 control group. Warm ischemia, cold ischemia and operative times of study group were 2.57 ± 2.03, 44.23 ± 8.89 and 189.6 ± 51.6 min, respectively, and that of control group were 2.67 ± 2.07, 42.37 ± 8.5 and 178.8 ± 54.6 min, respectively. The mean intraoperative blood loss in study and control groups was 124.83 ± 110.89 and 155 ± 50.27 ml, respectively, and the difference was statistically significant (p .027). The mean peri-graft collection in study group and control group were 72.33 ± 29.18 ml and 134.67 ± 102.84 ml, respectively, but the difference was not statistically significant (p .086). The study also demonstrated that the duration of hospital stays significantly differed between two groups (p < .043).
In this study, fibrin sealant has demonstrated both safety and efficacy in effectively managing bleeding, sealing vascular anastomoses, and mitigating peri-graft collection.
本研究旨在评估纤维蛋白密封剂在肾移植静脉吻合术中预防失血和术后移植肾周积液的疗效。
这是一项对印度一家三级医疗中心在1年期间进行的肾移植手术的回顾性分析病例对照研究。在此期间,纤维蛋白密封剂被随机用于静脉吻合术。提取所有数据并进行回顾性分析。使用纤维蛋白密封剂的患者为研究组,未使用密封剂的患者为对照组。主要目的是评估纤维蛋白密封剂在预防失血和术后移植肾周积液方面的有效性。次要目的是评估患者的人口统计学特征、住院时间以及其他术中及术后特征。
研究期间,共纳入163例患者,其中研究组82例,对照组81例。研究组的热缺血时间、冷缺血时间和手术时间分别为2.57±2.03、44.23±8.89和189.6±51.6分钟,对照组分别为2.67±2.07、42.37±8.5和178.8±54.6分钟。研究组和对照组的术中平均失血量分别为124.83±110.89和155±50.27毫升,差异具有统计学意义(p = 0.027)。研究组和对照组的移植肾周积液平均量分别为72.33±29.18和134.67±102.84毫升,但差异无统计学意义(p = 0.086)。该研究还表明,两组之间的住院时间存在显著差异(p < 0.043)。
在本研究中,纤维蛋白密封剂在有效控制出血、封闭血管吻合口和减轻移植肾周积液方面已证明具有安全性和有效性。