신장이식 1 , 200예에서 발생한 수술적 합병증 및 치료

Abstract

Surgical complication of renal transplantation may lead to the clisastrous consequence such as graft loss, patient`s morbidity and mortality. The incidence of surgical complication which had been up to 25% of renal transplantation in the past decreased below 10% or less. But the surgical complications are still significant causes of graft loss, postoperative morbidity and mortality. The incidence of early vascular complication is 3.5-8.0% and that of urologic complication is 9.0-12.5% in the literature review. Between the April l979 to August 1994, twelve hundred renal transplants were done at Yonsei University medical center. The authors analyzed the kinds and incidence of surgical complications in a large single center exp#erience by using the information from hospi#tal records. The results were as follows: The overall surgical complication rate is 9.3%(112 episodes in l01 patients). The majority of ation are postoperative bleeding(3.1% 38cases), urologic complications(3. 3% 40cases) and gastrointestinal bleeding(0.75% 9 cases). The other minor complications are wound hematoma, wound infection, wound disruption, incisional hernia and lymphocele. The most common vascular complication is postoperative bleeding or hematoma during early postoperative period. The most common urologic complication. Are urine leakage in early postoperative period and bladder stones in late period. The major type of postoperative complication in early period are bleeding & urine leakage and in late period are bladder stone, urinary obstruction and peptic ulcer disease. There were three complication related mortality. In conclusion, Atraumatic donor organ harvest, secure vascular anastomosis, water tight but not narrow ureteroneocystostomy, and meticulous hemostasis could keep surgical com- plications at a minimum. Early diagnosis followed by early agrressive surgical treatment could rescue both graft and patient.