Use of Haemostatic Agents and Glues during Laparoscopic Partial Nephrectomy

A Multi-Institutional Survey from the United States and Europe of 1347 Cases{A figure is presented}

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 & 7 others Claude C. Abbou, Richard Gaston, Gunter Janetschek, Naeem A. Soomro, Jean J. De la Rosette, Pilar M. Laguna, Peter G. Schulam

Research output: Contribution to journalArticle

85 Citations (Scopus)

Abstract

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 2.8 cm, 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.

Original languageEnglish
Pages (from-to)798-803
Number of pages6
JournalEuropean Urology
Volume52
Issue number3
DOIs
Publication statusPublished - Sep 2007

Fingerprint

Hemostatics
Nephrectomy
Adhesives
Urine
Hemorrhage
Neoplasms
oxidized cellulose
Cyanoacrylates
Fibrin Tissue Adhesive
Surveys and Questionnaires
Postal Service
Gelatin
Bovine Serum Albumin
Fibrin
Thrombin
Gels
Kidney

Keywords

  • Complications
  • Haemostatic agents
  • Laparoscopic partial nephrectomy
  • Sealants

ASJC Scopus subject areas

  • Urology

Cite this

Use of Haemostatic Agents and Glues during Laparoscopic Partial Nephrectomy : A Multi-Institutional Survey from the United States and Europe of 1347 Cases{A figure is presented}. / Breda, Alberto; Stepanian, Sevan V.; Lam, John S.; Liao, Joseph C.; Gill, Inderbir S.; Colombo, Jose R.; Guazzoni, Giorgio; Stifelman, Michael D.; Perry, Kent T.; Celia, Antonio; Breda, Guglielmo; Fornara, Paolo; Jackman, Stephen V.; Rosales, Antonio; Palou, Juan; Grasso, Michael; Pansadoro, Vincenzo; Disanto, Vincenzo; Porpiglia, Francesco; Milani, Claudio; Abbou, Claude C.; Gaston, Richard; Janetschek, Gunter; Soomro, Naeem A.; De la Rosette, Jean J.; Laguna, Pilar M.; Schulam, Peter G.

In: European Urology, Vol. 52, No. 3, 09.2007, p. 798-803.

Research output: Contribution to journalArticle

Breda, A, Stepanian, SV, Lam, JS, Liao, JC, Gill, IS, Colombo, JR, Guazzoni, G, Stifelman, MD, Perry, KT, Celia, A, Breda, G, Fornara, P, Jackman, SV, Rosales, A, Palou, J, Grasso, M, Pansadoro, V, Disanto, V, Porpiglia, F, Milani, C, Abbou, CC, Gaston, R, Janetschek, G, Soomro, NA, De la Rosette, JJ, Laguna, PM & Schulam, PG 2007, 'Use of Haemostatic Agents and Glues during Laparoscopic Partial Nephrectomy: A Multi-Institutional Survey from the United States and Europe of 1347 Cases{A figure is presented}', European Urology, vol. 52, no. 3, pp. 798-803. https://doi.org/10.1016/j.eururo.2007.02.035
Breda, Alberto ; Stepanian, Sevan V. ; Lam, John S. ; Liao, Joseph C. ; Gill, Inderbir S. ; Colombo, Jose R. ; Guazzoni, Giorgio ; Stifelman, Michael D. ; Perry, Kent T. ; Celia, Antonio ; Breda, Guglielmo ; Fornara, Paolo ; Jackman, Stephen V. ; Rosales, Antonio ; Palou, Juan ; Grasso, Michael ; Pansadoro, Vincenzo ; Disanto, Vincenzo ; Porpiglia, Francesco ; Milani, Claudio ; Abbou, Claude C. ; Gaston, Richard ; Janetschek, Gunter ; Soomro, Naeem A. ; De la Rosette, Jean J. ; Laguna, Pilar M. ; Schulam, Peter G. / Use of Haemostatic Agents and Glues during Laparoscopic Partial Nephrectomy : A Multi-Institutional Survey from the United States and Europe of 1347 Cases{A figure is presented}. In: European Urology. 2007 ; Vol. 52, No. 3. pp. 798-803.
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abstract = "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 2.8 cm, 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.",
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T1 - Use of Haemostatic Agents and Glues during Laparoscopic Partial Nephrectomy

T2 - A Multi-Institutional Survey from the United States and Europe of 1347 Cases{A figure is presented}

AU - Breda, Alberto

AU - Stepanian, Sevan V.

AU - Lam, John S.

AU - Liao, Joseph C.

AU - Gill, Inderbir S.

AU - Colombo, Jose R.

AU - Guazzoni, Giorgio

AU - Stifelman, Michael D.

AU - Perry, Kent T.

AU - Celia, Antonio

AU - Breda, Guglielmo

AU - Fornara, Paolo

AU - Jackman, Stephen V.

AU - Rosales, Antonio

AU - Palou, Juan

AU - Grasso, Michael

AU - Pansadoro, Vincenzo

AU - Disanto, Vincenzo

AU - Porpiglia, Francesco

AU - Milani, Claudio

AU - Abbou, Claude C.

AU - Gaston, Richard

AU - Janetschek, Gunter

AU - Soomro, Naeem A.

AU - De la Rosette, Jean J.

AU - Laguna, Pilar M.

AU - Schulam, Peter G.

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N2 - 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 2.8 cm, 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.

AB - 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 2.8 cm, 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.

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KW - Laparoscopic partial nephrectomy

KW - Sealants

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