Document Detail


Bovine serum albumin glutaraldehyde for completely sutureless laparoscopic heminephrectomy in a survival porcine model.
MedLine Citation:
PMID:  20059350     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Laparoscopic partial nephrectomy (LPN) has not received widespread clinical application because of its technical challenge. Bovine serum albumin glutaraldehyde (BSAG) is a hemostatic agent that is independent of the clotting cascade. We evaluated the use of BSAG as the sole agent for parenchymal and collecting system closure during LPN in a survival porcine model.
METHODS: Eighteen pigs underwent hilar clamping and LPN by longitudinal excision of the lateral one-third of the right kidney. The opened collecting system was covered with oxidized cellulose to prevent BSAG seepage into the urinary tract. BSAG was allowed to set for 10 or 5 minutes. Twelve animals underwent survival LPN BSAG only closure; six control pigs were acutely studied using saline. Urinary extravasation was evaluated by injection of furosemide and indigo carmine, and then evaluating the renal surface and bladder catheter drainage for dye. A subjective bleeding score was assigned after hilum unclamping. At 6 weeks, BSAG kidneys were harvested for burst pressure testing and histopathological analysis.
RESULTS: All 12 pigs survived for 6 weeks. No pigs had urinary extravasation. Mean percentage of kidney removed by weight was 19%. Mean warm ischemia time was 29 minutes. Five pigs required a second BSAG application to achieve a bleeding score of 0. Mean arterial and collecting system burst pressures were 301.8 and 322.4 mm Hg, respectively. Mean postoperative creatinine increase was 0.07 mg/dL.
CONCLUSION: BSAG for completely sutureless LPN in a survival porcine model was feasible.
Authors:
Michael K Louie; Aldrin Joseph R Gamboa; Adam G Kaplan; Amanda Khosravi; Hung Truong; Lorena Andrade; Rachelle Lin; Reza Alipanah; Cervando Ortiz; David McCormick; Geoffrey N Box; Hak J Lee; Leslie A Deane; Robert A Edwards; Elspeth M McDougall; Ralph V Clayman
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of endourology / Endourological Society     Volume:  24     ISSN:  1557-900X     ISO Abbreviation:  J. Endourol.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-25     Completed Date:  2010-06-30     Revised Date:  2013-08-25    
Medline Journal Info:
Nlm Unique ID:  8807503     Medline TA:  J Endourol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  451-5     Citation Subset:  IM    
Affiliation:
Department of Urology, University of California Irvine, Orange, California 92868, USA. louie@uci.edu
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MeSH Terms
Descriptor/Qualifier:
Animals
Glutaral / chemistry,  therapeutic use*
Laparoscopy*
Models, Animal*
Nephrectomy / methods*
Serum Albumin, Bovine / chemistry,  therapeutic use*
Survival Analysis
Sus scrofa / surgery*
Sutures*
Grant Support
ID/Acronym/Agency:
P30 CA062203/CA/NCI NIH HHS
Chemical
Reg. No./Substance:
0/Serum Albumin, Bovine; 111-30-8/Glutaral
Comments/Corrections

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