Background: The interest in vascular substitutes has recently increased. We evaluated the feasibility of using a homologous parietal peritoneum as a vascular substitute for venous reconstruction during abdominal surgery. Methods: The inferior vena cava was replaced with a homologous parietal peritoneum after cross-linking with glutaraldehyde in 36 rabbits. At 7, 14, and 28 days, the patency rate, outer and inner graft diameters, histology, and immunohistochemistry were evaluated. Results: Both the 7-and 14-day groups maintained vascular patency. Vascular patency was maintained in 3 rabbits in the 28-day group. The inner diameters of the anastomotic sites were 6.23 ± 0.18, 5.64 ± 0.16, and 2.34 ± 0.21 mm in the 7-day, 14-day, and 28-day groups, respectively. The midpoint inner diameters of the homologous parietal peritoneum grafts were 624 ± 0.46, 5.74 ± 0.26, and 2.14 ± 0.28 mm in each group, respectively. Endothelial cell proliferation on the homologous parietal peritoneum graft surfaces in all groups was based on the histological findings from the first group. Multiple neovascularizations of the homologous parietal peritoneum graft were found in the 14-and 28-day groups, indicating neomedia formation. Acute inflammation appeared to progress to the entire layer of the homologous parietal peritoneum graft without an intraluminal thrombus, but the graft was patent in the 14-day group. In the 28-day group, 6 rabbits showed near-total occlusion and a thrombus formed in the homologous parietal peritoneum graft at the anastomosis site with severe stricture; however, the rabbits were alive and had collateral vessel formation. Conclusion: Using homologous parietal peritoneum is feasible for venous reconstruction in abdominal surgery.

This study aimed to assess the safety of this procedure in children, including surgical complications and survival outcome following LDLT, to evaluate the effectiveness of open donor hepatectomy versus pure laparoscopic donor hepatectomy in a high-volume LDLT center. Methods: The medical records of 107 patients (aged 17 years) who underwent ABO compatible LDLT from May 2008 to June 2016 were analyzed. Of 107 patients, 76underwent open donor hepatectomy and 31 underwent pure laparoscopic donor hepatectomy. To overcome bias from the differing distribution of co-variables among patients in the two study groups, a 1:1 propensity score matching analysis was performed using the nearest-neighbor matching method. Results: The mean follow-up period was 92.9 months in the open group and 92.7 months in the laparoscopic group. The length of post-operative hospital stay of the donor was statistically shorter in the laparoscopic group than in the open group. The overall surgical complication rate did not differ between the groups. The 1-, 3-, and 5-year overall survival rates were 93.6%, 93.6%, and 93.6% in the open group and 96.8%, 93.6% and 93.6% in the laparoscopic group, respectively. Conclusions: Laparoscopic hepatectomy may be more beneficial for the donor, and the use of laparoscopic methods on the donor does not adversely affect the recipient s outcome. Thus, laparoscopic hepatectomy is a safe, feasible, and reproducible procedure for pediatric liver transplantation.