A Modified Technique of Renal Artery Anastomosis in Rat Kidney Transplantation

Zhang, G.; Zhao, Hui; Sun, Zhaolin

doi:10.1159/000262607

Cited by 7 publications

(3 citation statements)

References 23 publications

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“…At last, a fair method of validation is performing RCT comparison with conventional suture techniques in animals, which has been conducted in 14 studies included in this systematic review. [3][4][5][8][9][10][11][12][13][14][15][16][17][18] However, only one study among these RCTs succeeded in proper predictive validation, which has been mentioned earlier. 3 The validated techniques in these studies are merely modifications to existing anastomosis techniques or efforts to minimize steps in suturing anastomosis, aiming to reach a faster and more efficient anastomosis time, with the same or improved patency rate as conventional methods.…”

Section: Current Methods Of Technique Validationmentioning

confidence: 99%

Validation of Novel Microsurgical Vessel Anastomosis Techniques: A Systematic Review

Sadigh,

Mechri,

Jain

et al. 2024

J Reconstr Microsurg

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Introduction: Thorough validation of novel microsurgical techniques is deemed essential before their integration into clinical practice. To achieve proper validation, the design of randomized controlled trials (RCTs) should be undertaken, accompanied by the execution of comprehensive statistical analyses, including confounder adjustment and power analysis. This systematic review aims to provide an encompassing overview of the validation methodologies employed in microsurgical studies, with a specific focus on innovative vessel anastomosis techniques. Methods: A literature search was conducted in PubMed for articles describing the validation of novel microsurgical vessel anastomosis techniques in animal or human subjects. Results: The literature search yielded 6,658 articles. 6,564 articles were excluded based on title and abstract. Ninety-four articles were assessed for full-text eligibility. Forty-eight articles were included in this systematic review. Out of 30 comparative studies, nine studies validated novel modified interrupted suture techniques, six studies modified continuous techniques, six studies modified sleeve anastomosis techniques, one study a modified vesselotomy technique, seven studies sutureless techniques, and one study a modified lymphaticovenular anastomosis technique. Twenty-eight studies contained animals (n=1,998). Fifteen animal studies were RCTs. Two studies contained human/cadaveric subjects (n=29). Statistical power-analysis and confounder adjustment were performed in one animal study. Out of eighteen non-comparative studies, five studies validated novel modified interrupted suture techniques, one study a modified continuous technique, two studies modified sleeve anastomosis techniques, four studies modified vesselotomy techniques, four studies sutureless techniques, and two studies modified lymphaticovenular anastomosis techniques. Ten studies contained animal subjects (n=320), with two RCTs. Eight studies contained human subjects (n=173). Statistical power-analysis and confounder adjustment were performed in none of the animal or human studies. Conclusion: The current methods of microsurgical technique validation should be reconsidered due to poor study design. Statistical analysis including confounder adjustment and power-analysis should be performed as a standard method of novel technique validation.

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Section: Current Methods Of Technique Validationmentioning

confidence: 99%

Validation of Novel Microsurgical Vessel Anastomosis Techniques: A Systematic Review

Sadigh,

Mechri,

Jain

et al. 2024

J Reconstr Microsurg

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“…In one study, the warm ischemia time was 23.9 ± 0.9 versus 29.7 ± 1.1 minutes (P < .01), and the patency of the vessels was well maintained. 34 …”

Section: Application Of Fibrin Gluementioning

confidence: 99%

Untitled

Shrestha

Haylor²

2017

Exp Clin Transplant

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Microvascular surgical techniques of renal transplant in rats have evolved over the past 5 decades to achieve successful rat renal transplant; these modifications have included surgical techniques to address the anatomic variations in the renal blood vessels and those to reduce ischemic and operation durations. Here, we review the surgical techniques of renal transplant in rats and evaluate the advantages and disadvantages of individual techniques of vascular and ureteric anastomoses. For this review, we performed a systematic literature search using relevant medical subject heading terms and included appropriate publications in the review. Since the first description of a rat model of renal transplant by Bernard Fisher and his colleagues in 1965, which used end-to-side anastomosis between the renal vein and renal artery to the recipient inferior vena cava and aorta, several vascular and ureteric anastomosis techniques have been modified. Vascular anastomosis techniques now include end-to-end anastomosis, use of donor aortic and inferior vena cava conduits, sleeve and cuff anastomoses, and application of fibrin glue. Likewise, restoration of the urinary tract can now be achieved by direct anastomosis of the donor ureter to the recipient bladder, end-to-end anastomosis between the donor and recipient ureters, and donor bladder cuff to the recipient bladder. There are advantages and disadvantages attributable to individual techniques. The range of vascular and ureteric anastomosis techniques that has emerged reflects the need for mastering more than one technique to suit the vascular anatomy of individual animals and to reduce operating time for achieving successful outcomes after renal transplant.

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“…published a modified technique of renal artery anastamosis utilizing fibrin sealant in a series of renal transplantations in rats. [16] Gopal et al . and Ambriz-Gonzalez et al .…”

Section: Fibrin Sealantsmentioning

confidence: 99%

Evolution of hemostatic agents in surgical practice

Sundaram

Keenan

2010

Indian J Urol

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Objective:Topical hemostatic agents are used in a wide variety of surgical settings, and the evolution of this class of surgical tools is an interesting topic. We reviewed and outlined the historical progress of topical hemostats into present day surgery and urology, and highlight opportunities for future research.Materials and Methods:A MEDLINE search of all available literature concerning several classes of topical hemostatic agents was performed. Fibrins sealants, Gelatin sponge hemostatics, cyanoacrylate adhesives, oxidized regenerated cellulose, and microfibrillar collagen were included. References were chosen from a broad range of surgical literature.Results:Topical hemostatic agents have historically taken advantage of a wide variety of mechanisms for hemostasis. Fibrin sealants have a rich history and large potential for further applications. Gelatin sponge hemostatics have been widely used since their introduction, but have changed little. Cyanoacrylate adhesives have a unique mechanism and opportunity for novel applications of existing products. Oxidized cellulose was original in the use of plant-based components. Microfibrillar collagen hemostats have evolved to a wide variety of formats.Conclusions:A review of the evolution of topical hemostatic agents highlights opportunities for potential novel research. Fibrin sealants may have the most opportunity for advancement, and understanding the history of these products is useful. With the drive in urology for minimally invasive surgical techniques, adaptation of topical hemostatic agents to this surgical approach would be valuable and offers an opportunity for novel contributions.

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A Modified Technique of Renal Artery Anastomosis in Rat Kidney Transplantation

Cited by 7 publications

References 23 publications

Validation of Novel Microsurgical Vessel Anastomosis Techniques: A Systematic Review

Validation of Novel Microsurgical Vessel Anastomosis Techniques: A Systematic Review

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Evolution of hemostatic agents in surgical practice

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