Department of Urology, University Hospital Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee, Luebeck, Germany.
University Eye Clinic, Hannover Medical School, Hannover, Germany.
Adv Ther. 2021 Feb;38(2):1024-1034. doi: 10.1007/s12325-020-01584-8. Epub 2020 Dec 4.
Partial nephrectomy (PN) has evolved into the surgical standard of care for localized renal lesions. Hemostatic agents (HA) support the surgeon in achieving local hemostasis during PN. We previously reported initial results with the HA Hemopatch in PN. We now report our experiences with Hemopatch in a larger and more challenging single-surgeon PN cohort.
Our study included 45 patients who underwent PN due to suspicious renal lesions between December 2013 and March 2018. All surgeries were performed by a single surgeon using the HA Hemopatch. Preoperative, intraoperative, and postoperative parameters were assessed.
Preoperative median tumor diameter was 27 mm. Median PADUA and RENAL nephrometry scores were 7 and 6, respectively. In 13.3% of the cases an additional HA was applied. Intraoperative and postoperative bleeding occurred in 2.2% and 8.9%, respectively. Median total blood loss was 200 ml. Urgent pedicle clamping due to bleeding was necessary in 2 (4.4%) patients. The transfusion rate was 8.9%. There were no conversions.
We confirmed our initial results demonstrating feasibility and reliability of Hemopatch during PN. Notably, the cohort consists of selected patients. Prospective randomized studies are needed for comparison of different types of HA with regard to perioperative outcome.
部分肾切除术 (PN) 已成为治疗局限性肾病变的标准手术方法。止血剂 (HA) 可帮助外科医生在 PN 期间实现局部止血。我们之前报道了 HA Hemopatch 在 PN 中的初步结果。现在，我们报告了在更大、更具挑战性的单外科医生 PN 队列中使用 Hemopatch 的经验。
我们的研究纳入了 2013 年 12 月至 2018 年 3 月期间因可疑肾病变而行 PN 的 45 例患者。所有手术均由一名外科医生使用 HA Hemopatch 进行。评估了术前、术中及术后参数。
术前肿瘤直径中位数为 27mm。PADUA 和 RENAL 肾肿瘤评分中位数分别为 7 分和 6 分。分别有 13.3%和 2.2%的病例中应用了额外的 HA。术中及术后出血发生率分别为 2.2%和 8.9%。中位总失血量为 200ml。因出血需要紧急夹闭肾蒂的患者有 2 例（4.4%）。输血率为 8.9%。无中转开腹病例。
我们证实了我们的初步结果，表明在 PN 期间使用 Hemopatch 具有可行性和可靠性。值得注意的是，该队列包含了选定的患者。需要进行前瞻性随机研究，比较不同类型的 HA 在围手术期结局方面的差异。
