Short- and long-term outcomes of kidney transplants with kidneys lavaged by retrograde perfusion technique.

OBJECTIVE: To evaluate the clinical safety and efficacy of the retrograde perfusion technique in kidney transplantation. METHODS: Between January 2001 and June 2011, 24 cases of kidney transplantation with kidneys perfused using the retrograde perfusion technique due to renal artery variations or injury were selected as the observation group (retrograde perfussion group, RP group). Twenty-two cases of kidney transplantation via conventional perfusion were chosen as the control group (antegrade perfussion group, AP group). There were no statistically significant differences in donor data between the two groups. Cold ischemia time, warm ischemia time, renal perfusion time, amount of perfusion fluid, acute renal tubular necrosis, wound infection, urinary fistula, graft kidney function, and the 1-year, 3-year, and 5-year survival rates for the grafted kidney in both groups were observed and recorded. RESULTS: The kidney perfusion time was shorter in the RP group than that in the AP group (3.14 ± 1.00 vs. 5.02 ± 1.15 min, P = 0.030). There were 10 cases of acute renal tubule necrosis in the RP group and 5 in the AP group. The length of hospital stay was 40 ± 14 d in the RP group and 25 ± 12 d in the AP group. The follow-up time was 3.5-8.5 years (mean 6.25 years). The 1-, 3-, and 5-year survival rates for the grafted kidney were 95.8%, 75.5%, and 65.5% in the RP group and 97.1%, 82.5%, and 68.4% in the AP group, respectively (P>0.05). CONCLUSIONS: This study indicates that retrograde perfusion is safe and practicable for cadaveric kidney harvesting and can be regarded as a better alternative or remedial measure for a poorly perfused kidney due to vascular deformity or injury.

[Efficacy evaluation of laparoscopic gastric bypass for the treatment of obese type 2 diabetes mellitus].

OBJECTIVE: To explore the treatment outcomes of obese type 2 diabetes mellitus (T2DM) after laparoscopic gastric bypass. METHODS: The clinical data of 18 patients with obese T2DM who underwent laparoscopic Roux-en-Y gastric bypass in Beijing Shijitan Hospital between March 2009 and February 2011 were retrospectively analyzed. The clinical parameters included preoperative and postoperative blood glucose, blood lipid, nutrition status and weight lose. RESULTS: Eighteen patients included 8 men and 10 women. The range of age was 27-62 years (mean, 42.4±10.7 years). The range of BMI was 28.7-57.4 kg/m(2)(mean, 34.9±6.9 kg/m(2)). All the patients underwent laparoscopic Roux-en-Y gastric bypass, and no mortality, complication or conversion to open operation occurred. At 3 months after operation, there were significant changes in OGTT, BMI, HbA1c, Homa-IR and Homa-ß(all P<0.05). Fourteen patients(77.8%) showed clinical complete remission, and the overall effective rate was 100%(18/18). The level of blood lipid decreased significantly (P<0.05), and the change of nutritional status was not statistically significant(P>0.05). CONCLUSION: Gastric bypass is an effective treatment for obese type 2 diabetes mellitus.

[Transanal specimen extraction in laparoscopic colorectal resection].

OBJECTIVE: To investigate the feasibility and efficacy of transanal specimen extraction in laparoscopic colorectal resection. METHODS: From January 2009 to December 2010, transanal specimen extraction technique was performed in 12 patients undergoing laparoscopic colorectal resection. The clinical data were retrospectively analyzed. RESULTS: There were 8 males and 4 females. The age ranged from 41 to 67 (mean, 58) years old. The mean operative time was (240±45) min, mean blood loss was (70±40) ml. There was no anastomotic leakage or stenosis. One patient with constipation suffered from intractable right lower abdominal pain and was managed with antispasmodic agents. The frequency of bowel movements was 3-7/d in the 5 patients with constipation and 1-2/d in patients with colorectal carcinoma at six months postoperatively. No local recurrence and metastasis in patients with colorectal cancer after follow-up of 1-20 months. CONCLUSION: Transanal specimen extraction in laparoscopic colorectal resection is feasible, safe, and reliable.