Possibilities and limitations of fibrin glue usage in nephron-sparing surgery: experimental study.
BACKGROUND
The possibilities and limitations of fibrin glue (FG) usage in nephron-sparing surgery were studied.


METHODS
A prospective experimental study was carried out in 50 pigs: 30 with polar resection, and 20 with mediorenal wedge resection of the kidney. Hemostatic sutures, FG, and FG with a muscle 'cup' in animals with polar resection of the kidney were compared. FG and sutures in animals with the wedge resection of the kidney were studied as well. Bleeding, hot ischemia time, complication rate, and additional scarring were also analyzed.


RESULTS
Suture hemostasis is safe but with significant adverse effects in both polar and wedge resection of kidney. FG was not efficient as a sole hemostatic agent for polar resection. It was as efficient as hemostatic suture for wedge resection of the kidney. FG with a muscle 'cup' on a pole of the kidney achieved good results in animals with polar resection of the kidney. Histological analysis confirmed better results with FG because of both the less intense and smaller area of additional scarring.


CONCLUSIONS
FG is a reliable and efficient hemostatic agent for nephron-sparing surgery whenever both sided gluing is possible.
Stojkovic
Ivica
I
Clinic of Urology, Clinical Center Nis, Nis, Serbia and Montenegro.
Savic
Vojin
V
Djokic
Milan
M
Balint
Bela
B
Ljubenovic
Slobodan
S
Ignjatovic
Ivan
I
D000287:Administration, Topical; D000818:Animals; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D015718:Fibrin Tissue Adhesive / Q000008:administration & dosage*; D006488:Hemostasis, Surgical / Q000379:methods; D006490:Hemostatics / Q000008:administration & dosage*; D023421:Models, Animal; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D011446:Prospective Studies; D013552:Swine
D015718:Fibrin Tissue Adhesive; D006490:Hemostatics