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Bleeding during laparoscopic partial nephrectomy: Can a hemostatic matrix help to improve hemostasis?

Journal article
Authors Faruk Ozgor
Abdulmuttalip Simsek
Özgu Aydogdu
Onur Kucuktopcu
Omer Sarilar
Ahmet Yalcin Berberoglu
Mehmet Fatih Akbulut
Murat Binbay
Published in Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica
Volume 88
Issue 3
Pages 228-232
ISSN 1124-3562
Publication year 2016
Published at
Pages 228-232
Language en
Links dx.doi.org/10.4081/aiua.2016.3.228
www.ncbi.nlm.nih.gov/entrez/query.f...
Keywords Aged, Blood Loss, Surgical, prevention & control, Blood Transfusion, statistics & numerical data, Female, Follow-Up Studies, Gelatin Sponge, Absorbable, administration & dosage, Hemostatics, administration & dosage, Humans, Kidney Neoplasms, pathology, surgery, Laparoscopy, methods, Male, Middle Aged, Neoplasm Recurrence, Local, Nephrectomy, methods, Operative Time, Renal Artery, Retrospective Studies
Subject categories Urology and Nephrology

Abstract

To evaluate the possible role of an hemostatic matrix on hemostasis, perioperative outcomes and complications in patients who underwent laparoscopic partial nephrectomy (LPN).Patients charts were analyzed retrospectively and their demographic characteristics, operative parameters and follow-up results were recorded. Patients were divided into two groups, according to those who used an hemostatic matrix as Group 1 (n = 41) and those who did not used as Group 2 (n = 44). Demographic characteristics of patients, tumor features, operation time, clamping of the renal vessels, ischemia time, suturing of the collecting system, perioperative hemorrhage and complications were evaluated. Histopathological results, surgical margin status, creatinine level and recurrence at the 3rd month of follow up were analyzed. Statistical analyses were performed with SPSS 17.0 and significance was set at p value of < 0.05.The mean RENAL nephrometry score was 5.9 ± 2.0 and the mean tumor size was 35 ± 12 mm. All patients had a single tumor and 44 of them had a tumor in the right kidney. The renal artery was clamped in 79 cases and the mean ischemia time was 20.1 ± 7 minutes. The mean tumor size and the mean RENAL nephrometry score was statistically higher in Group 1 (p: 0.016 and p < 0.001, respectively). Pelvicaliceal repair was more common in Group 1 due to deeper extension of tumors in this group (p: 0.038). In Group 1, less hemorrhage and blood transfusion requirement, with shorter ischemia and operation time was detected.The outcomes of the recent study showed that adjunctive use of an hemostatic matrix improves hemostasis and decreases hemorrhagic complications during LPN. Further prospective studies are required to assess the potential role of an hemostatic matrix in LPN.

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