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Staehler, Michael; Rodler, S.; Schott, M.; Casuscelli, J.; Stief, C.; Spek, A. und Schlenker, B. (2021): Polyethylene glycol-coated collagen patch (hemopatch®) in open partial nephrectomy. In: World journal of urology [PDF, 909kB]

Abstract

PURPOSE To describe the results of a polyethylene glycol-coated collagen patch, Hemopatch® on blood loss, surgical time and renal function in partial nephrectomy (PN) for renal cell carcinoma (RCC). METHODS Out of a single surgeon cohort of n = 565 patients undergoing conventional open PN (CPN) between 01/2015 and 12/2017 at the University of Munich a consecutive subgroup (n = 42) was operated on using a polyethylene glycol-coated collagen-based sealant Hemopatch® (Baxter International Inc., Deerfield, IL, USA) (HPN). RESULTS Median age was 65.2~years (range 12.7-95.2) with median follow-up of 9.43~months (0.03-49.15). Baseline renal function (CKD-EPI) was 78.56~ml/min/1.73~m2 (range 20.38-143.09) with a non-significant decline to 74.78~ml/min/1.73~m2 (range 3.75-167.74) at follow-up. In CPN 46% had low complexity, 33% moderate complexity and 20% high complexity lesions with 33% low, 40% moderate and 27% high complexity masses in HPN. Median tumor size was 4.3~cm (range 1-38~cm) in CPN with 4.8~cm (range 3.8-18.3~cm) with HPN, p = 0.293. Median blood loss and duration of surgery was significantly lower in the HPN group vs. CPN (146~ml ± 195 vs. 114~ml ± 159~ml; p = 0.021; 43~min ± 27 for HPN vs. 53~min ± 49; p = 0.035) with no difference in clamping time (12.6~min ± 8.6 for HPN vs. 12.0~min ± 9.5; p = 0.701). CONCLUSIONS Hemopatch® supported renoraphy shows promising results compared to standard renoraphy in PN. No side effects were seen. Further studies should evaluate the prevention of arterio-venous or urinary fistulas. In complex partial nephrectomies Hemopatch® supported renoraphy should be considered.

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