Canlı vericili karaciğer nakli öncesi radyolojik değerlendirme:median arkuat ligaman basısının transplantasyonsonrası komplikasyonlara etkisi
Küçük Resim Yok
Tarih
2023
Yazarlar
Dergi Başlığı
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Cilt Başlığı
Yayıncı
İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Çalışmada median arkuat ligaman (MAL) basısı bulunan canlı donörlerin alıcılarında bu sendromun ameliyat sonrası komplikasyonlara etkisinin araştırılması ve doğru donör seçimine katkı sağlanılması amaçlanmaktadır. Materyal ve Metot: 1 Ocak 2020 ile 30 Haziran 2022 arasında dinamik abdomen bilgisayarlı tomografileri (BT) çekilen 2745 donör adayı retrospektif olarak tarandı. Belirtilen tarih aralığındaki tüm hastaların BT'leri tüm planlardan (axial, sagittal ve koronal) değerlendirilerek median arkuat ligaman basısı olup olmadıkları teyit edildi. Hem MAL basısı bulunan ve ameliyat olunan donör adaylarının, hem de MAL basısı bulunmayan ve ameliyat olunan kontrol grubu donör adaylarının alıcılarında gelişen komplikasyon oranları tespit edildi ve karşılaştırıldı. Bulgular: Çalışmamıza dahil edilen 2745 donör adayından, 156'sında (%5,7) MAL basısı bulgularına rastlanırken 2589'unda (%94,3) MAL basısı bulgularına rastlanmamıştır. 2745 donör adayından 575 donör operasyona alınmıştır. 575 donörün %7 (39)'sinde (hasta grubu) MALS tanısına rastlanırken, %93(536)'ünde (kontrol grubu) rastlanmamıştır. Opere olan 575 donörün MALS tanılı olanlarının %28 (11)'si kadın, %72 (28)'i erkek iken MALS tanısı konulmayan donörlerin %38 (204)'i kadın, %62 (332)'inin erkek olduğu görülmüştür. Çalışmada operasyon sonrası alıcılarda gelişen komplikasyon oranları incelenmiş, hasta ve kontrol grubu arasında genel olarak anlamlı farklılığın olmadığı anlaşılmıştır. Fakat komplikasyonlar ayrı ayrı ele alındığında MAL basısı bulunan donörlerin alıcılarında gelişen bilier komplikasyonların MAL basısı bulunmayan donörlerin alıcılarında gelişen bilier komplikasyonlardan daha fazla olduğu ortaya koyulmuştur. Sonuç: Bu çalışma, Median Arkuat Ligaman basısı bulunan donörlerin alıcılarında nakil sonrası bu sendromun gelişen komplikasyonlar üzerindeki etkisini değerlendirmiştir. Bulgularımız, MAL basısı olan donörlerin alıcılarında artmış bilier komplikasyon oranını göstermekte olup donör seçiminde bu durumun göz önünde bulundurulması gerekliliğini ortaya koymaktadır. Anahtar kelimeler: Median Arkuat Ligaman Sendromu (MALS), donör, CVKN, komplikasyon.
Objective: The study aims to investigate the effect of postoperative complications in recipients of live donors with median arcuate ligament compression syndrome and contribute to the accurate selection of donors. Materials and Methods: Between January 1, 2020, and June 30, 2022, dynamic abdominal computed tomographies of 2745 donor candidates were retrospectively reviewed. Abdominal computed tomographies of all patients within the specified date range were evaluated in all planes (axial, sagittal, and coronal) to confirm the presence of median arcuate ligament compression. The complication rates in recipients of both donor candidates with MAL compression and those without MAL compression who underwent surgery were determined and compared. Results: Among the 2745 donor candidates included in our study, median arcuate ligament (MAL) compression was found in 156 (5.7%), while no MAL compression findings were observed in 2589 (94.3%). Out of 2745 donor candidates, 575 donors underwent surgery. Among these donors, 7% (39) were diagnosed with MALS (patient group), while 93% (536) were not (control group). Among the 575 operated donors with MALS diagnosis, 28% (11) were female and 72% (28) were male, whereas among the donors without MALS diagnosis, 38% (204) were female and 62% (332) were male. Complication rates in recipients after surgery were examined in the study, and although there was no significant overall difference between the patient and control groups, when complications were considered separately, it was revealed that recipients of donors with MAL compression had a higher incidence of biliary complications compared to those without MAL compression. Conclusion: This study evaluates the impact of Median Arcuate Ligament compression on post-transplant complications in recipients of donors. Our findings suggest that donors with MAL compression may have an increased risk of biliary complications in ix recipients, emphasizing the need to be cautious when selecting donors with this syndrome. Keywords: MALS, donor, LDLT, complication.
Objective: The study aims to investigate the effect of postoperative complications in recipients of live donors with median arcuate ligament compression syndrome and contribute to the accurate selection of donors. Materials and Methods: Between January 1, 2020, and June 30, 2022, dynamic abdominal computed tomographies of 2745 donor candidates were retrospectively reviewed. Abdominal computed tomographies of all patients within the specified date range were evaluated in all planes (axial, sagittal, and coronal) to confirm the presence of median arcuate ligament compression. The complication rates in recipients of both donor candidates with MAL compression and those without MAL compression who underwent surgery were determined and compared. Results: Among the 2745 donor candidates included in our study, median arcuate ligament (MAL) compression was found in 156 (5.7%), while no MAL compression findings were observed in 2589 (94.3%). Out of 2745 donor candidates, 575 donors underwent surgery. Among these donors, 7% (39) were diagnosed with MALS (patient group), while 93% (536) were not (control group). Among the 575 operated donors with MALS diagnosis, 28% (11) were female and 72% (28) were male, whereas among the donors without MALS diagnosis, 38% (204) were female and 62% (332) were male. Complication rates in recipients after surgery were examined in the study, and although there was no significant overall difference between the patient and control groups, when complications were considered separately, it was revealed that recipients of donors with MAL compression had a higher incidence of biliary complications compared to those without MAL compression. Conclusion: This study evaluates the impact of Median Arcuate Ligament compression on post-transplant complications in recipients of donors. Our findings suggest that donors with MAL compression may have an increased risk of biliary complications in ix recipients, emphasizing the need to be cautious when selecting donors with this syndrome. Keywords: MALS, donor, LDLT, complication.
Açıklama
Anahtar Kelimeler
Radyoloji ve Nükleer Tıp, Radiology and Nuclear Medicine
