Wang H, Fu YX, Song WL, Mo CB, Feng G, Zhao J, Pei GH, Shi XF, Wang Z, Cao Y, Nian YQ, Shen ZY. Suture ligation for submucosal hemostasis during hand-sewn side-to-side duodeno-ileostomy in simultaneous pancreas and kidney transplantation. World J Gastrointest Surg 2021; 13(9): 988-999 [PMID: 34621475 DOI: 10.4240/wjgs.v13.i9.988]
Corresponding Author of This Article
Ying-Xin Fu, MD, Chief Doctor, Department of Kidney and Pancreas Transplant, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fukang Road, Nankai District, Tianjin 300192, China. yingxinfu@nankai.edu.cn
Research Domain of This Article
Transplantation
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Hui Wang, Ying-Xin Fu, Wen-Li Song, Chun-Bai Mo, Gang Feng, Jie Zhao, Guang-Hui Pei, Xiao-Feng Shi, Zhen Wang, Yu Cao, Ye-Qi Nian, Zhong-Yang Shen, Department of Kidney and Pancreas Transplant, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin 300192, China
Author contributions: Wang H contributed to acquisition of data and wrote the manuscript; Fu YX and Shen ZY provided substantial contribution to the conception and design of the study and corrected the manuscript; Song WL, Mo CB, Feng G, Zhao J, Pei GH, Shi XF and Wang Z performed operations and provided study materials of the patients; Cao Y and Nian YQ contributed to acquisition of data, analysis, and interpretation of data.
Supported byNational Natural Science Foundation of China, No. 81970654.
Institutional review board statement: The study was approved by the clinical research ethics committee of the Tianjin First Central Hospital.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors have no conflict of interest related to the manuscript.
Data sharing statement: The anonymous dataset is available on request from the corresponding author at yingxinfu@nankai.edu.cn.
STROBE statement: The authors have read the STROBE Statement, and the manuscript was prepared and revised according to the STROBE Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ying-Xin Fu, MD, Chief Doctor, Department of Kidney and Pancreas Transplant, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fukang Road, Nankai District, Tianjin 300192, China. yingxinfu@nankai.edu.cn
Received: March 22, 2021 Peer-review started: March 22, 2021 First decision: May 13, 2021 Revised: May 17, 2021 Accepted: August 10, 2021 Article in press: August 10, 2021 Published online: September 27, 2021 Processing time: 180 Days and 6.5 Hours
ARTICLE HIGHLIGHTS
Research background
As a potentially life-threatening complication of simultaneous pancreas and kidney transplantation (SPKT), enteric anastomotic (EA) bleeding frequently results in surgical relaparotomy and graft loss; therefore, it is essential to decrease the incidence of EA bleeding.
Research motivation
An effort was made for submucosal hemostasis during enteric anastomosis in SPKT with a lower EA bleeding rate.
Research objectives
To investigate the advantages and disadvantages of suture ligation (SL) for submucosal hemostasis during enteric anastomosis on early EA bleeding and anastomotic leakage in SPKT.
Research methods
We compared the outcomes of 134 patients classified into SL (n = 44) and no SL (NSL) groups (n = 90).
Research results
During the first postoperative week, the EA bleeding rate in the SL group was lower than that in the NSL group during the first postoperative week. No relationship was found between EA bleeding and donor age, mean pancreatic cold ischemia time, platelet count, prothrombin time international normalized rate, activated partial thromboplastin time, and thrombin time. No significant difference was noted between the two groups in terms of the anastomotic leakage rate, patient survival curve, pancreas graft survival curve, or kidney graft survival curve.
Research conclusions
Compared with no SL, SL for submucosal hemostasis during enteric anastomosis in SPKT can decrease the EA bleeding rate and do not increase the anastomotic leakage rate.
Research perspectives
Further clinical randomized controlled studies with a large sample size are needed to confirm the effect of plication techniques on submucosal hemostasis during enteric anastomosis in SPKT in the future.
