Document Detail

Use of haemostatic agents and glues during laparoscopic partial nephrectomy: a multi-institutional survey from the United States and Europe of 1347 cases.
MedLine Citation:
PMID:  17329015     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Laparoscopic partial nephrectomy (LPN) is a technically challenging procedure for the management of renal tumours. Major complications of LPN include bleeding and urine leakage. Haemostatic agents (HAs) and/or glues may reduce haemorrhage and urine leakage. We sought to examine the current practice patterns for urologists performing LPN with regard to HA use and its relationship with bleeding and urine leakage. MATERIALS AND METHODS: A survey was sent via e-mail to urologists currently performing LPN in centres in the United States and Europe. We queried the indications for HA/glue usage, type of HAs/glues used, and whether concomitant suturing/bolstering was performed. In addition, the total number of LPNs performed, laparoscopic tools used to resect the tumour, tumour size, and tumour position were queried. RESULTS: Surveys suitable for analysis were received from 18 centres (n=1347 cases). HAs and/or glues were used in 1042 (77.4%) cases. Mean tumour size was 2.8cm, with 79% of the tumours being defined as exophytic and 21% deep. The HAs and glues used included gelatin matrix thrombin (FloSeal), fibrin gel (Tisseel), bovine serum albumin (BioGlue), cyanoacrylate glue (Glubran), oxidized regenerated cellulose (Surgicel), or combinations of these. Sixteen centres performed concomitant suturing/bolstering. The overall postoperative bleeding requiring transfusion and urine leakage rates were 2.7% and 1.9%, respectively. CONCLUSIONS: The use of HAs and/or glues is routine in most centres performing LPN. The overall haemorrhage and urine leakage rates are low following LPN. More studies are needed to assess the potential role of HAs and/or glues in LPN.
Alberto Breda; Sevan V Stepanian; John S Lam; Joseph C Liao; Inderbir S Gill; Jose R Colombo; Giorgio Guazzoni; Michael D Stifelman; Kent T Perry; Antonio Celia; Guglielmo Breda; Paolo Fornara; Stephen V Jackman; Antonio Rosales; Juan Palou; Michael Grasso; Vincenzo Pansadoro; Vincenzo Disanto; Francesco Porpiglia; Claudio Milani; Claude C Abbou; Richard Gaston; Gunter Janetschek; Naeem A Soomro; Jean J De la Rosette; Pilar M Laguna; Peter G Schulam
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Publication Detail:
Type:  Journal Article; Multicenter Study     Date:  2007-02-22
Journal Detail:
Title:  European urology     Volume:  52     ISSN:  0302-2838     ISO Abbreviation:  Eur. Urol.     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-08-03     Completed Date:  2007-12-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7512719     Medline TA:  Eur Urol     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  798-803     Citation Subset:  IM    
Copyright Information:
European Association of Urology.
Department of Urology, David Geffen School of Medicine at the University of California-Los Angeles, Los Angeles, California, USA.
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MeSH Terms
Blood Loss, Surgical / prevention & control*
Hemostatics / therapeutic use*
Kidney Neoplasms / surgery*
Laparoscopy / methods*
Nephrectomy / methods*
Retrospective Studies
Suture Techniques*
Tissue Adhesives / therapeutic use*
United States
Reg. No./Substance:
0/Hemostatics; 0/Tissue Adhesives
Comment In:
Eur Urol. 2007 Sep;52(3):803   [PMID:  17329013 ]

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