RESUMEN
PURPOSE: The metal ring pin stapler was initially developed for microvascular surgery and there has been little experience of their use in larger vessels. We determined if the titanium ring pin coupling system could be safely and rapidly applied for arterial reconstruction in clinical renal transplantation. MATERIALS AND METHODS: The donor renal artery was end-to-end anastomosed to the internal iliac artery with titanium ring pin staplers in 36 patients. Anastomotic, clamp and total operative time and vascular problems were compared with those in the control group of sutured anastomosis in 39 transplant recipients. RESULTS: The completion of mechanical anastomosis required half the time of suture anastomosis. Mean clamp time was 17.8 minutes in the nonsuture group and 28.1 minutes in the control group. There was no significant difference in total operative time between the 2 groups. A small anastomotic line leak was noted in each group, which was temporary and self-limited. There were no postoperative anastomotic failures, postoperative bleeding episodes or need to revise the anastomosis (100% patency rate) in the 2 groups. Of the patients 61 were followed for 2 to 5 years. Transplant renal artery stenosis was observed in 1 patient in the nonsuture group but 3 in the control group. CONCLUSIONS: The anastomotic technique with the ring pin system is safe and simple, permitting an expeditious and everting anastomosis with a smooth intima-to-intima junction. Application of this technique may decrease warm ischemia time and the incidence of anastomotic artery stenosis, thus, improving outcomes.
Asunto(s)
Trasplante de Riñón/métodos , Arteria Renal/cirugía , Engrapadoras Quirúrgicas , Adulto , Anastomosis Quirúrgica , Diseño de Equipo , Femenino , Humanos , Masculino , Procedimientos Quirúrgicos Vasculares/métodosRESUMEN
OBJECTIVE: To observe the change of sexual function in male kidney transplant recipients. METHODS: Sixty married males, aged 26 to 45 years, who had received kidney transplantations at least half a year before and whose serum creatinine (Scr) was under 200 mumol/L, were selected randomly in the study. Sexual functions were reviewed before and after the patients' renal failure and after kidney transplantations. The results were analyzed in Chi-Square test methods. RESULTS: Their sexual functions, significantly aggravated after renal failure, were improved after kidney transplantations, but failed to return to normal. The recipients had a common worry that their sex lives might affect the renal grafts. CONCLUSIONS: Kidney transplantations significantly improve the sexual functions of these renal failure patients. It is quite necessary to provide sexological guidance to kidney transplant recipients and their spouses.