title: A new technique--"lipocorticoplasty"--for the closure of partial nephrectomy defects and its comparison with the standard technique.
abstract: OBJECTIVE
  We describe a new technique that can easily be used as a tension-free practical alternative in closing the renal defects resulting after open partial nephrectomy (PN).
  
  
  METHODS
  A new technique (called "lipocorticoplasty") where "wrapped fatty tissue" was placed in the tumor crater to close the renal defects that occur following PN is reported in 10 consecutive patients who underwent PN between May 2006 and January 2009 (Group I). Patients were compared with equal number of consecutive patients who underwent standard open PN before January 2009 (Group II) in terms of operative time, bleeding, tumor size, drain removal time, postoperative length of stay (PLOS), complications, and functional and oncological follow-up. Postoperative follow-up included physical examination, laboratory tests, and radiological screening at 3-month intervals for the first year, at 6-month intervals for the second year, and annually thereafter.
  
  
  RESULTS
  Mean tumor size (35.2 vs. 33.8 mm), operative time (156 vs. 165 min), bleeding (650 vs. 765 cc), drain removal time (2.8 vs. 2.5 POD), and PLOS (4.4 vs. 4.2 POD) were not statistically different between Group I and Group II, respectively. No intraoperative complications occurred. Postoperatively, transient complications without any permanent sequela were observed in 3 (1 in Group I and 2 in Group II) patients. Mean follow-up time was 16.1 months (7-26) in Group I and 19.1 months (8-36) in Group II. None of the patients had local or systemic recurrence at follow-up.
  
  
  CONCLUSIONS
  Our new technique provides obvious benefits in local hemostasis, simplifies parenchymal suturing, obviates the need for coaptation of the edges of the tumor bed defect under tension, and minimizes nephron loss due to kinking and tearing of renal parenchyma in the closure of the renal defects following open renal tumor excision.
authors.affiliation: School of Medicine, Urology Department, Kocaeli University, Kocaeli, Turkey.
authors.forename: Levend
authors.initials: L
authors.lastname: Ozkan
authors.forename: Ali
authors.initials: A
authors.lastname: Saribacak
authors.forename: Cem
authors.initials: C
authors.lastname: Taneri
authors.forename: Cuneyd
authors.initials: C
authors.lastname: Ozkurkcugil
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Cevik
authors.forename: Ozdal
authors.initials: O
authors.lastname: Dillioglugil
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000601:surgery*; D004322:Drainage; D006488:Hemostasis, Surgical / Q000379:methods; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D007902:Length of Stay; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D013536:Suture Techniques / Q000009:adverse effects; D013997:Time Factors; D047368:Tumor Burden