Haemostatics in surgery and our experience in the enucleoresection of renal cell carcinoma.
BACKGROUND
30 patients, with T1 renal cell carcinomas (RCC) who underwent open enucleoresection of the tumour, were randomized to the use of a topical haemostatic agent (Floseal) or to an infrared-sapphire coagulator (ISC), to compare their efficacy in achieving haemostasis.


METHODS
Successful intra-operative haemostasis, intra- and post-operative bleeding, operative time, hospital discharge were evaluated.


RESULTS
Statistically higher rates of successful haemostasis and shorter time-to-haemostasis (8,1 vs 12,9 min) were observed in the FloSeal group (p < 0.001 both). Patients operative time was not different between Group 1 vs 2 (58.7 +/- 12 vs 62.4 +/- 15; p > 0.05). The average blood loss during surgery was less (60 +/- 25.5 mL) for the FloSeal group than for the ISC group (85 +/- 40.5 mL) (p < 0.05). Postoperative blood loss was 25 +/- 5 mL and 40 +/- 45 mL for Floseal and ISC respectively, (p < 0.05). Length of the postoperative hospital discharge was 2.5 +/- 1.2 days for FloSeal group and 3.5 +/- 1.3 for the Group 2 (p < 0.05). No major immediate or delayed complications were observed in either Groups.


CONCLUSIONS
The use of Floseal and ISC offer a safe and efficacy haemostasis in the enucleoresection of RCC. Moreover, our results show a less intra-operative and post-operative blood loss as well as a shorter time to haemostasis of Floseal in respect to ISC.
Pace
Gianna
G
Department of Surgical Sciences, University of L'Aquila, San Salvatore Street, Palace 6 A, Coppito, 67100 L'Aquila, Italy. giannapace@gmail.com
Saldutto
Pietro
P
Vicentini
Carlo
C
Miano
Lucio
L
D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000601:surgery*; D005260:Female; D005781:Gelatin Sponge, Absorbable / Q000627:therapeutic use*; D006488:Hemostasis, Surgical / Q000379:methods*; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D015996:Survival Rate; D016896:Treatment Outcome
C411004:FloSeal Matrix; D006490:Hemostatics
Arch Ital Urol Androl. 2008 Sep;80(3):85-91
19009862
JSLS. 2009 Apr-Jun;13(2):226-8
19660222
J Trauma. 2006 Feb;60(2):385-9
16508500
Surg Innov. 2008 Sep;15(3):194-202
18757379
Clin Adv Hematol Oncol. 2004 Jul;2(7):428, 431
16163216
Eur J Obstet Gynecol Reprod Biol. 2009 May;144 Suppl 1:S142-5
19304365
J Endourol. 2009 Oct;23(10):1739-41
19785557
Acta Neurochir (Wien). 2009 Jan;151(1):69-77; discussion 77
19129962
BJU Int. 2009 Mar;103(5):663-8
18990172
J Trauma. 2006 Feb;60(2):346-50
16508494
AJR Am J Roentgenol. 2008 Nov;191(5):1371-3
18941071
Am J Obstet Gynecol. 2009 Apr;200(4):e10-1
19114270
J Minim Invasive Gynecol. 2009 Mar-Apr;16(2):224-6
19249715
J Surg Res. 2009 Jul;155(1):77-81
19181342
Eur Urol. 2007 Jun;51(6):1502-10
17408850
Spine (Phila Pa 1976). 2009 Jun 1;34(13):E473-7
19478651
J Trauma. 2009 Mar;66(3):602-11
19276727
J Endourol. 2007 Mar;21(3):315-20
17444778
J Minim Invasive Gynecol. 2009 Mar-Apr;16(2):153-6
19138574
Urology. 2009 Jan;73(1):172-7
18950843
Urology. 2005 May;65(5):994-7
15882740
BJU Int. 2008 Sep;102(8):1005-7
18564131
Urology. 2009 Jul;74(1):202-5
19428068
J Neurosurg. 2009 May;110(5):939-42
19061356
Neurosurgery. 2008 Oct;63(4 Suppl 2):369-72; discussion 372
18981845
Prostate Cancer Prostatic Dis. 2009;12(3):301-9
19104507
Langenbecks Arch Surg. 2009 Sep;394(5):837-42
19421770
Fertil Steril. 2009 Jul;92(1):356-60
19423098
Curr Med Res Opin. 2008 Apr;24(4):1011-5
18291065
J Endourol. 2009 Feb;23(2):279-82
19196066
J Endourol. 2009 Jun;23(6):929-32
19473063
Neurol Neurochir Pol. 2009 Jul-Aug;43(4):346-51
19742393
J Endourol. 2005 Nov;19(9):1114-21
16283850
Eur Urol. 2006 Feb;49(2):337-42; discussion 342-3
16413957
Eur Urol. 2007 Sep;52(3):798-803
17329015
J Endourol. 2005 Jul-Aug;19(6):614-7; discussion 617
16053347
J Endourol. 2007 Aug;21(8):872-8
17867944
J Endourol. 2005 Apr;19(3):312-7
15865520
Ann Thorac Surg. 2009 Nov;88(5):1520-6
19853105
J Endourol. 2009 Jan;23(1):43-9
19178171
Arch Gynecol Obstet. 2009 Jul;280(1):161-5
19238415