title: Hemostatic role of a folkloric medicinal plant extract in a rat partial nephrectomy model: controlled experimental trial.
abstract: OBJECTIVE
  Ankaferd BloodStopper is a mixture of 5 plants used in traditional Turkish medicine as hemostatic agent for external traumatic, postoperative and dental bleeding. We investigated the hemostatic efficacy of Ankaferd BloodStopper for partial nephrectomy.
  
  
  METHODS
  A total of 24 Wistar rats were divided into 4 groups of 6 each. Group 1 underwent partial nephrectomy with hilar control as the conventional technique. Group 2 underwent the conventional technique with hemostatic agent application. Group 3 underwent hemostatic agent application to the renal parenchyma. In Group 4 partial nephrectomy was performed and the hemostatic agent was used without hilar control. Warm ischemia and partial nephrectomy times, and the number of hemostatic agent applications were recorded. Histopathological evaluations were completed. The Fisher, Kruskal-Wallis and Mann-Whitney U tests were used for statistical analysis.
  
  
  RESULTS
  Mean kidney size was 2 x 2.5 x 0.05 cm. Mean partial nephrectomy time was 3.7, 2.7, 1.8 and 3.2 minutes in groups 1 to 4, respectively, which was significantly different between groups 1 and 3 (p = 0.007). Warm ischemia time in group 3 was less than in group 1 (p = 0.011). The number of hemostatic agent applications was higher in groups 3 and 4 compared to those in group 2 (p = 0.003). Glomerular necrosis was detected at a higher rate in group 1 compared to that in groups 3 and 4 (p = 0.015). Calcification formed significantly more in group 1 than in groups 2 to 4 (p <0.05). Erythrocyte aggregation was greater in groups 2 to 4 than in group 1 (p = 0.015). Giant cell reaction, fibrosis, inflammation and microvascular proliferation were not statistically different among the groups (p >0.05).
  
  
  CONCLUSIONS
  Ankaferd BloodStopper decreases partial nephrectomy and warm ischemia times, and provides hemostasis. Erythrocyte aggregation confirmed the hemostatic action of the agent, while the absence of glomerular necrosis and calcification may have positive relevance.
authors.affiliation: Second Urology Clinic, Ankara Training and Research Hospital, Ankara, Turkey. dremrehuri@yahoo.com
authors.forename: Emre
authors.initials: E
authors.lastname: Huri
authors.forename: Turgay
authors.initials: T
authors.lastname: Akgül
authors.forename: Ali
authors.initials: A
authors.lastname: Ayyildiz
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Ustün
authors.forename: Cankon
authors.initials: C
authors.lastname: Germiyanoğlu
mesh_terms: D000818:Animals; D001707:Biopsy, Needle; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D004195:Disease Models, Animal; D005260:Female; D006489:Hemostatic Techniques; D006490:Hemostatics / Q000008:administration & dosage*; D007150:Immunohistochemistry; D008297:Male; D016343:Monitoring, Intraoperative; D009392:Nephrectomy; D008517:Phytotherapy / Q000379:methods*; D010936:Plant Extracts / Q000494:pharmacology*; D010946:Plants, Medicinal; D011336:Probability; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D052096:Warm Ischemia
chemical_list: D006490:Hemostatics; D010936:Plant Extracts