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手术中的止血剂和我们在肾细胞癌剜除术中的经验。

Haemostatics in surgery and our experience in the enucleoresection of renal cell carcinoma.

机构信息

Department of Surgical Sciences, University of L'Aquila, San Salvatore Street, Palace 6 A, Coppito, 67100 L'Aquila, Italy.

出版信息

World J Surg Oncol. 2010 May 12;8:37. doi: 10.1186/1477-7819-8-37.

Abstract

BACKGROUND

30 patients, with T1 renal cell carcinomas (RCC) who underwent open enucleoresection of the tumour, were randomized to the use of a topical haemostatic agent (Floseal) or to an infrared-sapphire coagulator (ISC), to compare their efficacy in achieving haemostasis.

METHODS

Successful intra-operative haemostasis, intra- and post-operative bleeding, operative time, hospital discharge were evaluated.

RESULTS

Statistically higher rates of successful haemostasis and shorter time-to-haemostasis (8,1 vs 12,9 min) were observed in the FloSeal group (p < 0.001 both). Patients operative time was not different between Group 1 vs 2 (58.7 +/- 12 vs 62.4 +/- 15; p > 0.05). The average blood loss during surgery was less (60 +/- 25.5 mL) for the FloSeal group than for the ISC group (85 +/- 40.5 mL) (p < 0.05). Postoperative blood loss was 25 +/- 5 mL and 40 +/- 45 mL for Floseal and ISC respectively, (p < 0.05). Length of the postoperative hospital discharge was 2.5 +/- 1.2 days for FloSeal group and 3.5 +/- 1.3 for the Group 2 (p < 0.05). No major immediate or delayed complications were observed in either Groups.

CONCLUSIONS

The use of Floseal and ISC offer a safe and efficacy haemostasis in the enucleoresection of RCC. Moreover, our results show a less intra-operative and post-operative blood loss as well as a shorter time to haemostasis of Floseal in respect to ISC.

摘要

背景

30 例 T1 期肾细胞癌(RCC)患者接受肿瘤开放性剜除术,随机使用局部止血剂(Floseal)或红外蓝宝石凝固器(ISC),比较两种方法止血效果。

方法

评估术中止血成功、术中及术后出血、手术时间、住院出院情况。

结果

Floseal 组术中止血成功率和止血时间(8,1 与 12,9 分钟)均显著更高(均 p < 0.001)。两组患者手术时间无差异(第 1 组 58.7 +/- 12 与第 2 组 62.4 +/- 15;p > 0.05)。Floseal 组术中出血量(60 +/- 25.5 mL)明显少于 ISC 组(85 +/- 40.5 mL)(p < 0.05)。Floseal 组和 ISC 组术后出血量分别为 25 +/- 5 mL 和 40 +/- 45 mL(p < 0.05)。Floseal 组术后住院时间为 2.5 +/- 1.2 天,ISC 组为 3.5 +/- 1.3 天(p < 0.05)。两组均未发生严重的即刻或迟发性并发症。

结论

Floseal 和 ISC 在肾细胞癌剜除术中均可安全有效地止血。此外,与 ISC 相比,Floseal 术中及术后出血量更少,止血时间更短。

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