Partial nephrectomy using porcine small intestinal submucosa

World Journal of Surgical Oncology

Andres J Schrader¹  Mark Schrader¹  Friedemann Zengerling¹  Sandra Waalkes²  Florian Jentzmik¹  Robert Hefty¹  Robert de Petriconi¹  Thomas J Schnoeller¹ 

[1] Department of Urology, Ulm University Medical Center, Prittwitzstrasse 43, D-89075 Ulm, Germany;Department of Urology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625 Hannover, Germany

关键词: complications;    postoperative hemorrhage;    urinoma;    nephron-sparing surgery;    renal cell carcinoma;   

Others  :  1206638
DOI  :  10.1186/1477-7819-9-126

 received in 2011-05-25, accepted in 2011-10-12,  发布年份 2011

【 摘 要 】

Background

Whenever technically feasible and oncologically justified, nephron-sparing surgery is the current standard of care for localized renal cell carcinomas (RCC). The main complications of partial nephrectomy, especially for large and centrally located tumors, are urinary leakage and parenchymal bleeding. We prospectively evaluated the pros and cons of using porcine small intestinal submucosa (SIS, Surgisis^®) to close the renal defect after nephron-sparing surgery.

Methods

We used Surgisis^® (Cook medical, Bloomington, IN, USA) to secure and compress the capsular defect after tumor resection in 123 patients submitted to 129 partial nephrectomies between August 2003 and February 2011.

Results

The median tumor size was 3.7 cm (range 1.1-13.0 cm). Procedures were performed with cold ischemia in 24 cases (18.2%), with warm ischemia in 46 (35.6%), and without ischemia in 59 cases (44.8%). In the total group of patients, 4 (3.1%) developed urinary fistula, and only 2 (1.6%) required postoperative transfusions due to hemorrhage after the application of the small intestinal submucosa membrane.

Conclusion

Small intestinal submucosa is an easy-to-use biomaterial for preventing complications such as postoperative bleeding and urinary fistula in nephron-sparing surgery, especially in cases where tumor excision causes significant renal capsular and/or renal pelvic defects.

【 授权许可】

   
2011 Schnoeller et al; licensee BioMed Central Ltd.

【 图 表 】

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