First experience: Open small incision rectus sheath approach renal transplant: A case series
| Autor: | Stephen Phillips, Joseph B. Africa, Sharon Hill, Lorie Lipscomb |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Operative Time Surgical Wound Rectus Abdominis 030232 urology & nephrology 030230 surgery 03 medical and health sciences 0302 clinical medicine Risk Factors medicine Humans Surgical Wound Infection Kidney transplantation Aged Retrospective Studies business.industry Medical record General Medicine Rectus sheath Perioperative Middle Aged medicine.disease Kidney Transplantation Surgery Transplantation Treatment Outcome medicine.anatomical_structure Renal transplant Small incision Drainage Operative time Female business |
| Zdroj: | International Journal of Surgery. 39:114-118 |
| ISSN: | 1743-9191 |
| DOI: | 10.1016/j.ijsu.2017.01.076 |
| Popis: | Background Prevention of wound complications is an important goal in surgery, and reduction of modifiable risks factors are an important step towards protecting patients from further complications. Renal transplantation has sought to be more inclusive giving access to transplantation to complex patient populations, many of which have an increased risk of complications specifically obese recipients. Surgical techniques continue to advance and may contribute to reducing complications. We hypothesized that the Anterior Rectus Sheath (ARS) Approach would provide an open transplant with minimal damage and less wound complications, including fluid collections such as lymphoceles, when compared to the conventional technique (CON) with equivalent graft function and survival. Materials and methods The ARS approach was adopted at our center in November of 2012. Medical records for 44 patients that underwent kidney transplantation at our Center between May 1, 2012 and March 31, 2013 were reviewed with data collected up to August 2015. Two were excluded (2 intraperitoneal transplants), leaving 22 in the ARS group and 20 in the CON group. Results Demographics, data, and perioperative factors were found to be similar, but operative and post-operative findings indicated significant differences between the groups. Significant reductions of wound complications, including fluid collections, were observed and operative time, incision length, and drain usage were improved with the ARS technique. Secondary outcome assessing overall patient outcomes showed no significant difference. Conclusion This retrospective review case series quantified that this easily adopted modification of the conventional transplant technique is a safe, effective, and swift approach to renal transplantation with favorable graft results and improved surgical outcomes with less post-operative wound complications. |
| Databáze: | OpenAIRE |
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