Secure reconstruction technique after partial nephrectomy irrespective of tumor size and location
Int. braz. j. urol
; 35(4): 416-426, July-Aug. 2009. ilus, tab
Article
en En
| LILACS
| ID: lil-527199
Biblioteca responsable:
BR1.1
ABSTRACT
Introduction:
Nephron-sparing surgery for large renal masses is not considered a safe procedure because of high complication rate. We present our experience using expanded polytetrafluoroethylene (Gore-Tex®) and Hem-O-Lok® (Weck® Clip) as hemostatic agents during open partial nephrectomy (OPN) to perform nephron-sparing surgery for large renal masses. Materials andMethods:
Sixty patients underwent OPN for suspicious renal cell carcinomas. Thirty-four patients with tumors < 2.5 cm in size underwent OPN with Gore-Tex® alone (group 1). Clinical data from a computerized database were reviewed and compared to a contemporary group of 26 patients with tumors ≥ 2.5 cm in size who underwent OPN with Gore-Tex® and Hem-O-Lok® (group 2).Results:
The mean patient age was 53 years (range, 35-85 years), and the mean duration of follow-up was 41.8 months (range, 6-56 months). The mean cold ischemic times were 24.0 minutes (range, 12-37 minutes) and 35.3 minutes (range, 18-65 minutes) respectively in group 1 and 2. The tumor sizes in groups 1 and 2 were 1.7 ± 0.4 cm and 4.74 ± 2.75 cm, respectively. No major complications, such as urine leakage or delayed bleeding, were noted in either group.Conclusions:
Nephron-sparing surgery using Gore-Tex® alone or a Gore-Tex® and Hem-O-Lok® combination was safe without high-priced hemostatic agents because the tensile strength was sufficient to maintain firmness in the repaired parenchyma. In addition, the procedure is easy to perform and takes less time to complete. Furthermore, major complications, recurrence, and impaired renal function did not occur with this procedure.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
LILACS
Asunto principal:
Politetrafluoroetileno
/
Carcinoma de Células Renales
/
Angiomiolipoma
/
Hemostasis Quirúrgica
/
Neoplasias Renales
/
Nefrectomía
Tipo de estudio:
Observational_studies
Límite:
Aged
/
Aged80
/
Humans
Idioma:
En
Revista:
Int. braz. j. urol
Asunto de la revista:
UROLOGIA
Año:
2009
Tipo del documento:
Article
País de afiliación:
Corea del Sur
Pais de publicación:
Brasil