Background.
Chylous ascites (CA) is an extremely rare complication after laparoscopic donor nephrectomy (LDN). It can increase the hospital stay, morbidity in postoperative period and thus negating the benefits of laparoscopic surgery. Most of the cases were managed conservatively, but surgical intervention may be occasionally required. This report describes the importance of accurate localization of the leaking chyle duct and its repair by endosuturing in a renal donor not responding to conservative treatment.
Methods.
A comprehensive review of literature regarding this rare complication after LDN was performed with Pubmed/Medline and Google Scholar using “chyle,” “complications,” and “laparoscopic donor nephrectomy” as keywords. The demographic profile and management of patients is discussed in detail. The various surgical modalities used to manage these patients are described.
Results.
Fifty-four cases of chyle leak/ascites have been reported after LDN in literature to date. Around 77% donors with CA could be successfully managed conservatively with dietary measures and total parenteral nutrition. Surgical intervention was required in nearly 23% donors ranging from clip application, use of argon coagulation, endosuturing with application of glue after 36.1 ± 19.07 days of failed conservative treatment. Donors with massive ascites or requiring frequent large-volume paracentesis on conservative treatment are likely to require surgical therapy. The present case was successfully managed with laparoscopic endosuturing and has no recurrence at 6 month follow-up.
Conclusions.
Chylous ascites is a rare complication after donor nephrectomy in experienced centers. Although conservative management remains the first line of treatment, early surgical treatment shall be undertaken in cases of massive ascites.
DAAs including Sofosbuvir, Daclatasvir and Ledipasvir with or without ribavirin are safe and effective for the treatment of chronic hepatitis C in renal transplant recipients.
ABSTRACT%Aim: To compare the effect of different chemical solvents on glass fiber reinforced posts and to study the effect of these solvents on the shear bond strength of glass fiber reinforced post to core material.Materials and methods: This study was conducted to evaluate the effect of three chemical solvents, i.e. silane coupling agent, 6% H2O2 and 37% phosphoric acid on the shear bond strength of glass fiber post to a composite resin restorative material. The changes in post surface characteristics after different treatments were also observed, using scanning electron microscopy (SEM) and shear bond strength was analyzed using universal testing machine (UTM).Results: Surface treatment with hydrogen peroxide had greatest impact on the post surface followed by 37% phosphoric acid and silane. On evaluation of the shear bond strength, 6% H2O2 exhibited the maximum shear bond strength followed in descending order by 37% phosphoric acid and silane respectively.Conclusion: The surface treatment of glass fiber post enhances the adhesion between the post and composite resin which is used as core material. Failure of a fiber post and composite resin core often occurs at the junction between the two materials. This failure process requires better characterization.How to cite this article: Sharma A, Samadi F, Jaiswal JN, Saha S. A Comparative Evaluation of Effect of Different Chemical Solvents on the Shear Bond Strength of Glass Fiber Reinforced Post to Core Material. Int J Clin Pediatr Dent 2014;7(3):192-196.
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