Mathew Jeni Elizabeth, Pal Atanu Kumar, Kishore Thekke Adiyat
Department of Urology, Aster Medcity, Kochi, India.
J Endourol. 2025 Sep;39(9):911-916. doi: 10.1089/end.2024.0844. Epub 2025 Jun 19.
Renorrhaphy during partial nephrectomy is technically challenging and can extend the warm ischemia time (WIT). This study investigates the use of Veriset™ as an alternative to renorrhaphy in robot-assisted partial nephrectomy (RAPN) and presents our findings. In this retrospective analysis, 43 patients who had Veriset patch placed on the tumor bed post resection were compared against 43 patients who underwent conventional single-layer renorrhaphy for RAPN from January 2023 to January 2024 at our institution. The two groups underwent propensity score matching based on age, body mass index, and R.E.N.A.L. nephrometry score. Data of all patients, including patient demographic details, tumor characteristics including size, location, pre- and postoperative blood investigations, intraoperative findings, blood loss, postoperative course, complications, and follow-up of 6 months duration, were recorded. The mean age of the study population was 52.62 ± 13.31 years, and the mean nephrometry score was 6.64 ± 1.91. The Veriset patch application failed in three patients (6.97%) and cortical renorrhaphy had to be performed for hemostasis. The Veriset group (VG) had significantly less console time and WIT when compared with renorrhaphy group (RG) (82.02 ± 25.17 minutes and 11.95 ± 10.02 minutes, respectively, 95.53 ± 29.80 minutes and 17.63 ± 6.59 minutes; = 0.014 and < 0.001, respectively). The RG witnessed a significant reduction in estimated glomerular filtration rate (eGFR) on postoperative day 1 as opposed to VG (-7.56 ± 15.89 mL/min/1.73 m -0.21 ± 11.12 mL/min/1.73 m; = 0.015). The intraoperative blood loss, need for blood transfusion, postoperative change in hemoglobin rates, readmission, and renal function at 6 months in the VG and RG were comparable. The Veriset application instead of renorrhaphy led to reduced WIT, decreased console time, and early return of renal function with no significantly increased rate of complications.
部分肾切除术期间的肾缝合术在技术上具有挑战性，并且可能延长热缺血时间（WIT）。本研究调查了在机器人辅助部分肾切除术（RAPN）中使用Veriset™替代肾缝合术的情况，并展示了我们的研究结果。在这项回顾性分析中，将2023年1月至2024年1月在我们机构接受RAPN且术后在肿瘤床放置Veriset补片的43例患者与43例接受传统单层肾缝合术的患者进行比较。两组基于年龄、体重指数和R.E.N.A.L.肾计量评分进行倾向得分匹配。记录了所有患者的数据，包括患者人口统计学细节、肿瘤特征（包括大小、位置）、术前和术后血液检查、术中发现、失血量、术后病程、并发症以及6个月的随访情况。研究人群的平均年龄为52.62±13.31岁，平均肾计量评分为6.64±1.91。3例患者（6.97%）的Veriset补片应用失败，不得不进行皮质肾缝合术以止血。与肾缝合术组（RG）相比，Veriset组（VG）的控制台时间和WIT显著更短（分别为82.02±25.17分钟和11.95±10.02分钟，95.53±29.80分钟和17.63±6.59分钟；P分别为0.014和<0.001）。与VG相反，RG在术后第1天的估计肾小球滤过率（eGFR）显著降低（-7.56±15.89 mL/min/1.73 m²对-0.21±11.12 mL/min/1.73 m²；P = 0.015）。VG和RG的术中失血量、输血需求、术后血红蛋白率变化、再次入院情况以及6个月时的肾功能相当。使用Veriset替代肾缝合术可减少WIT、缩短控制台时间并使肾功能早期恢复，且并发症发生率无显著增加。
