Application of parachute suture technique in variant donor renal artery anastomosis of living-donor renal transplantation
10.3760/cma.j.cn115396-20230208-00020
- VernacularTitle:降落伞缝合技术在活体肾移植变异供肾动脉吻合中的应用
- Author:
Lei ZHANG
1
;
Meishan ZHAO
;
Zhipeng WANG
;
Jian ZHANG
;
Yang YANG
;
Guangpu DING
;
Yichen ZHU
Author Information
1. 首都医科大学附属北京友谊医院泌尿中心，北京 100050
- Keywords:
Living donors;
Kidney transplantation;
Suture techniques;
Renal artery abnormalities;
Arteriovenous anastomosis
- From:
International Journal of Surgery
2023;50(6):385-390,F2
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effects and advantages of parachute technique in arterial anastomosis of living-donor renal transplantation with anatomical variations of renal artery.Methods:A total of 79 pairs of donors and recipients who received living-donor renal transplantation at the Department of Urology, Beijing Friendship Hospital, Capital Medical University from January 2020 to November 2022 were retrospectively collected. 11 pairs with completeness data and multiple donor renal arteries were selected. According to the different techniques, the cases using parachute technique were classified as experimental group and other cases as control group using traditional two-three-point fixation technique. There were 5 pairs in the experimental group and 6 pairs in the control group. The medical records of the two groups were collected, containing general data, the state of donated kidney, the arterial reonstruction method, the condition of perioperation and recovery of recipients. Measurement data were expressed as mean ± standard deviation ( ± s). Student- t test was used for inter-group comparison. The Chi-square test or Fisher exact probability method were used to compare the count data of groups. Results:The donations of experimental group and control group were left-sided kidney. There were no statistical difference in age, gender, body mass index and estimated glomerular filtration rate of donors and recipients. The average number of renal arteries in the experimental group was 2.2, and that in the control group was 2.0. There were no statistical difference between the two groups in the mean time of transplantation surgery[(152.0±23.9) min vs (148.3±24.0) min], estimated blood loss [(90.0±41.8) mL vs (91.7±58.5) mL] and mean arterial anastomosis time [(21.0±5.4) min vs (20.8 ± 4.7) min]. At the end of arterial anastomosis, no case in the experimental group need acupuncture or secondary anastomosis, while the control group had 3 cases, the difference was statistically significant ( P=0.002). There was no statistical difference in the recovery of renal function and complications related to renal arteries between the two groups ( P>0.05). Conclusions:Parachute suture technique can more accurately achieve the purpose of layer-to-layer eversion suture of vascular wall under the condition of narrow arterial lumen, and will not significantly prolong the operation time. It may have a good application value in living kidney transplantation with renal artery variation.
