A Modified Surgical Technique Using Cyanoacrylate Glue and Parenchymal Restoration Sutures without Tissue Approximation in Patients with Renal Tumors Who Underwent Open Partial Nephrectomy
Journal Title: Journal of Urological Surgery - Year 2019, Vol 6, Issue 2
Abstract
Objective: To investigate the results of a modified open partial nephrectomy technique by using cyanoacrylate glue after the parenchymal restoration sutures without performing tissue reapproximation and to compare complications between risk groups according to the preoperative aspects and dimensions used for an anatomical (PADUA) classification in 50 patients. Materials and Methods: We performed open partial nephrectomy by using cyanoacrylate glue in 50 patients with a localized tumor and normal contralateral kidney between 2005 and 2012 with a mean follow-up of 40 months. All patients were evaluated by routine biochemical analyses and imaging modalities such as abdominal tomography and magnetic resonance when needed. PADUA scores were assessed according to the computed tomography images. Results: The mean blood loss was higher and the duration of surgery and ischemia was longer in high-risk group than in low-risk group. The difference was statistically significant (p=0.001, p=0.004, and p=0.0009, respectively. Intraoperative collecting system restoration was performed in 3 (9.9%) low-risk and 10 (50%) high-risk patients. Collecting system fistulization or chronic renal failure was not observed in any patient. Conclusion: Application of cyanoacrylate adhesive in nephron-sparing surgery is safe and effective in patients with a low PADUA risk score. Further randomized and controlled studies in a large series of patients will provide more conclusive results.
Authors and Affiliations
Önder Kayıgil, Evren Işık, Emrah Okulu
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