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The role of hemostatic agents in preventing complications in laparoscopic partial nephrectomy

INTRODUCTION: Nephron-sparing surgery is currently the treatment of choice for renal cell carcinoma stage T1a. During the past years, several hemostatic agents (HA) have been developed in order to reduce surgical complications. We present the results of our series and the impact of the use of HA in...

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Autores principales: Carrion, Diego M., y Gregorio, Sergio Alonso, Rivas, Juan Gómez, Bazán, Alfredo Aguilera, Sebastián, Jesús Díez, Martínez-Piñeiro, Luis
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Polish Urological Association 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5791400/
https://www.ncbi.nlm.nih.gov/pubmed/29410886
http://dx.doi.org/10.5173/ceju.2017.1432
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author Carrion, Diego M.
y Gregorio, Sergio Alonso
Rivas, Juan Gómez
Bazán, Alfredo Aguilera
Sebastián, Jesús Díez
Martínez-Piñeiro, Luis
author_facet Carrion, Diego M.
y Gregorio, Sergio Alonso
Rivas, Juan Gómez
Bazán, Alfredo Aguilera
Sebastián, Jesús Díez
Martínez-Piñeiro, Luis
author_sort Carrion, Diego M.
collection PubMed
description INTRODUCTION: Nephron-sparing surgery is currently the treatment of choice for renal cell carcinoma stage T1a. During the past years, several hemostatic agents (HA) have been developed in order to reduce surgical complications. We present the results of our series and the impact of the use of HA in the prevention of surgical complications in laparoscopic partial nephrectomies (LPNs). MATERIAL AND METHODS: We retrospectively analyzed all LPN performed in our center from 2005 to 2012. A total of 77 patients were included for analysis. Patients were divided into two groups: Group A (no use of HA) and Group B (use of HA). HA used included gelatin matrix thrombin (FloSeal) and oxidized regenerated cellulose (Surgicel). Demographics, perioperative variables, and complications were analyzed with a special interest in postoperative bleeding and urinary leakage. RESULTS: Median age was 57.17 years old (±12.1), 72.7% were male, most common comorbidities were hypertension (33.8%) and diabetes mellitus (18.2%). All patients had one solitary tumor, and 87% had a tumor ≤4 cm. Renal cell carcinoma was found in 79.2% of cases, and 78.7% were stage pT1a. and were used in 36 cases (46.8%). No differences were found in demographics, perioperative variables, and complications between groups. No conversions to open surgery or perioperative mortality were reported. CONCLUSIONS: We conclude that in our series the use of a hemostatic agent did not offer benefit in reducing the complication rate over sutures over a bolster.
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spelling pubmed-57914002018-02-06 The role of hemostatic agents in preventing complications in laparoscopic partial nephrectomy Carrion, Diego M. y Gregorio, Sergio Alonso Rivas, Juan Gómez Bazán, Alfredo Aguilera Sebastián, Jesús Díez Martínez-Piñeiro, Luis Cent European J Urol Original Paper INTRODUCTION: Nephron-sparing surgery is currently the treatment of choice for renal cell carcinoma stage T1a. During the past years, several hemostatic agents (HA) have been developed in order to reduce surgical complications. We present the results of our series and the impact of the use of HA in the prevention of surgical complications in laparoscopic partial nephrectomies (LPNs). MATERIAL AND METHODS: We retrospectively analyzed all LPN performed in our center from 2005 to 2012. A total of 77 patients were included for analysis. Patients were divided into two groups: Group A (no use of HA) and Group B (use of HA). HA used included gelatin matrix thrombin (FloSeal) and oxidized regenerated cellulose (Surgicel). Demographics, perioperative variables, and complications were analyzed with a special interest in postoperative bleeding and urinary leakage. RESULTS: Median age was 57.17 years old (±12.1), 72.7% were male, most common comorbidities were hypertension (33.8%) and diabetes mellitus (18.2%). All patients had one solitary tumor, and 87% had a tumor ≤4 cm. Renal cell carcinoma was found in 79.2% of cases, and 78.7% were stage pT1a. and were used in 36 cases (46.8%). No differences were found in demographics, perioperative variables, and complications between groups. No conversions to open surgery or perioperative mortality were reported. CONCLUSIONS: We conclude that in our series the use of a hemostatic agent did not offer benefit in reducing the complication rate over sutures over a bolster. Polish Urological Association 2017-10-17 2017 /pmc/articles/PMC5791400/ /pubmed/29410886 http://dx.doi.org/10.5173/ceju.2017.1432 Text en Copyright by Polish Urological Association http://creativecommons.org/licenses/by-nc-sa/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
spellingShingle Original Paper
Carrion, Diego M.
y Gregorio, Sergio Alonso
Rivas, Juan Gómez
Bazán, Alfredo Aguilera
Sebastián, Jesús Díez
Martínez-Piñeiro, Luis
The role of hemostatic agents in preventing complications in laparoscopic partial nephrectomy
title The role of hemostatic agents in preventing complications in laparoscopic partial nephrectomy
title_full The role of hemostatic agents in preventing complications in laparoscopic partial nephrectomy
title_fullStr The role of hemostatic agents in preventing complications in laparoscopic partial nephrectomy
title_full_unstemmed The role of hemostatic agents in preventing complications in laparoscopic partial nephrectomy
title_short The role of hemostatic agents in preventing complications in laparoscopic partial nephrectomy
title_sort role of hemostatic agents in preventing complications in laparoscopic partial nephrectomy
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5791400/
https://www.ncbi.nlm.nih.gov/pubmed/29410886
http://dx.doi.org/10.5173/ceju.2017.1432
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