Partial nephrectomy using porcine small intestinal submucosa

World Journal of Surgical Oncology

Research

Sandra Waalkes¹  Friedemann Zengerling²  Thomas J Schnoeller²  Robert de Petriconi²  Robert Hefty²  Andres J Schrader²  Florian Jentzmik²  Mark Schrader² 

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

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

DOI  :  10.1186/1477-7819-9-126

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

来源: Springer

【 摘 要 】

BackgroundWhenever 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.MethodsWe 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.ResultsThe 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.ConclusionSmall 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】

Unknown   
© Schnoeller et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.