Rozanski Alexander T, Viers Boyd R, Liu Alexander G, Shakir Nabeel A, Pagliara Travis J, Scott Jeremy M, West Mary L, Morey Allen F
Department of Urology, UT Southwestern Medical Center, Dallas, TX.
Department of Urology, UT Southwestern Medical Center, Dallas, TX.
Urology. 2017 Oct;108:190-194. doi: 10.1016/j.urology.2017.06.002. Epub 2017 Jun 9.
To report our initial experience with oxidized regenerated cellulose (ORC; Surgicel Fibrillar) as a hemostatic adjunct during inflatable penile prosthesis (IPP) surgery.
Beginning in April 2016, ORC pledgets were placed within the corporotomy closures of all men undergoing IPP insertion. Perioperative characteristics and outcomes including cumulative postoperative drain output were evaluated among consecutive cases with (April 2016 to October 2016) and without ORC (December 2015 to March 2016) using an identical surgical technique by a single surgeon.
During the study period, 64 men underwent IPP implantation, of whom 32 (50%) received ORC. There was a significant reduction in median drain output relative to controls (33 mL vs 65 mL; P = .01). Postoperatively, ORC use was associated with a reduction in the number of patient phone calls for scrotal-related concerns in the immediate postoperative period (average 0.5 vs 1.1; P = .03). There were 3 IPP explantations in the non-ORC group (2/3 for infection)-one of which was directly related to an infected hematoma. After controlling for other clinical features, the use of ORC (β -32, 95% confidence interval: -61 to -5; P = .02) was independently associated with a reduction in drain output.
ORC use during IPP corporotomy closure reduces postoperative drain output, a known risk factor for hematoma-related complications.
报告我们在可膨胀阴茎假体(IPP)手术中使用氧化再生纤维素(ORC;Surgicel Fibrillar)作为止血辅助材料的初步经验。
从2016年4月开始,将ORC小块放置在所有接受IPP植入手术男性的阴茎海绵体切口闭合处。对2016年4月至10月使用ORC的连续病例和2015年12月至2016年3月未使用ORC的连续病例,采用单一外科医生相同的手术技术,评估围手术期特征和结果,包括术后累计引流量。
在研究期间,64名男性接受了IPP植入,其中32名(50%)接受了ORC。与对照组相比,中位引流量显著减少(33毫升对65毫升;P = 0.01)。术后,使用ORC与术后短期内因阴囊相关问题患者致电次数减少有关(平均0.5次对1.1次;P = 0.03)。非ORC组有3例IPP取出(2/3因感染),其中1例与感染性血肿直接相关。在控制其他临床特征后,使用ORC(β -32,95%置信区间:-61至-5;P = 0.02)与引流量减少独立相关。
在IPP阴茎海绵体切口闭合时使用ORC可减少术后引流量,而术后引流量是血肿相关并发症的已知危险因素。