Bahouth Zaher, Moskovitz Boaz, Halachmi Sarel, Nativ Ofer
Department of Urology, Bnai-Zion Medical Center, Golomb 47, Haifa, Israel.
Department of Urology, Bnai-Zion Medical Center, Faculty of Medicine, Technion, Haifa, Israel.
Ther Adv Urol. 2017 Feb 1;9(3-4):67-72. doi: 10.1177/1756287217697662. eCollection 2017 Mar-Apr.
To present the operative and post-operative comparison between patients who underwent tumor-bed closure with sutures compared with bovine serum albumin-glutaraldehyde (BioGlue) tissue sealant only.
We retrospectively analyzed data from our ongoing database of 507 eligible patients who underwent open NSS nephron-sparing surgery in our department between January 1995 and May 2014. Patients had tumor-bed closure with sealant adhesive (255 patients) or standard suture technique (252 patients). Demographic, clinical and perioperative data were compared between the two groups, by Chi-square test or by Fisher-Irwin exact test for categorical variables, and by test for differences in means or by Wilcoxon rank sum test for continuous variables. A multivariate analysis was also done.
Patients' baseline characteristics showed similar distribution of the analyzed parameters among both groups, with few differences: younger age in the sealant group (65.4 68.4 years, = 0.01) and slightly larger mass size in the suture group (4.0 3.9 cm, = 0.03). Ischemia time was significantly shorter in the sealant group (21.8 27.0 minutes, = 0001). Blood loss and transfusion rate (0.8% 11.9%, = 0.0001) were significantly less in the sealant group. A multivariate analysis showed date of surgery and blood loss as the major parameters affecting transfusion rate.
Closing the tumor bed with BioGlue tissue adhesive is feasible, safe, can shorten ischemia time and potentially reduce transfusion rate.
比较仅使用牛血清白蛋白 - 戊二醛（BioGlue）组织密封剂与使用缝线进行肿瘤床闭合的患者的手术及术后情况。
我们回顾性分析了1995年1月至2014年5月间在我院接受开放性保留肾单位手术的507例符合条件患者的数据库资料。患者分为使用密封剂粘合剂闭合肿瘤床组（255例）和标准缝合技术组（252例）。对两组患者的人口统计学、临床及围手术期数据进行比较，分类变量采用卡方检验或Fisher - Irwin精确检验，连续变量采用均值差异检验或Wilcoxon秩和检验。同时进行多因素分析。
两组患者的基线特征显示，分析参数的分布相似，仅有少数差异：密封剂组患者年龄较轻（65.4对68.4岁，P = 0.01），缝合组肿块尺寸略大（4.0对3.9 cm，P = 0.03）。密封剂组的缺血时间显著缩短（21.8对27.0分钟，P = 0.0001）。密封剂组的失血量和输血率（0.8%对11.9%，P = 0.0001）显著更低。多因素分析显示手术日期和失血量是影响输血率的主要参数。
使用BioGlue组织粘合剂闭合肿瘤床是可行、安全的，可缩短缺血时间并可能降低输血率。
