Difference of clinical efficacy between surgical magnifying glass and surgical microscope assisted hepatic artery reconstruction in living donor liver transplantation
10.3969/j.issn.1674-7445.2020.05.009
- VernacularTitle:活体肝移植术中使用手术放大镜与手术显微镜行肝动脉重建的疗效差异
- Author:
Jian YANG
1
;
Yan XIE
;
Dazhi TIAN
;
Xiaoye SUN
;
Wentao JIANG
Author Information
1. The First Central College of Tianjin Medical University, Tianjin 300110, China
- Publication Type:Research Article
- Keywords:
Living donor liver transplantation;
Hepatic artery reconstruction;
Surgical microscope;
Binocular magnifying glass for surgery;
Perioperative period;
Model for end-stage liver disease (MELD) score;
Child-Pugh grading;
Hepatic artery thrombosis
- From:
Organ Transplantation
2020;11(5):584-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the difference of clinical efficacy between surgical magnifying glass and surgical microscope assisted hepatic artery reconstruction in living donor liver transplantation (LDLT). Methods Clinical data of 272 donors and recipients undergoing LDLT were retrospectively analyzed. According to different patterns of hepatic artery reconstruction, all recipients were divided into the magnifying glass group (n=189) and microscope group (n=83). The operation time, intraoperative blood loss, hepatic artery reconstruction site, diameter of anastomosis, incidence of postoperative complications and survival rate of recipients were statistically compared between two groups. Results Compared with the microscope group, the operation time, hepatic artery reconstruction time and intraoperative blood loss were significantly less in the magnifying glass group (all P < 0.001). The most common site of hepatic artery reconstruction was the right hepatic artery in two groups, and the diameter of anastomosis was (2.1±0.9) mm in the magnifying glass group and (2.1±0.8) mm in the microscope group, with no statistical significance between two groups (P > 0.05). The 1-, 2- and 3-year survival rates of recipients in the magnifying glass group were 88%, 86% and 85%, which did not significantly differ from 89%, 87% and 86% in the microscope group (all P > 0.05). The incidence of postoperative complications did not significantly differ between two groups (all P > 0.05). Conclusions The efficacy and safety of hepatic artery reconstruction in LDLT under surgical magnifying glass are equivalent to those under surgical microscope, with less operation workload and intraoperative blood loss. For experienced transplantation surgeons, it is recommended to perform hepatic artery reconstruction assisted by surgical magnifying glass.
