title: Partial nephrectomy using porcine small intestinal submucosa.
abstract: BACKGROUND
  Whenever technically feasible and oncologically justified, nephron-sparing surgery is the current standard of care for localized renal cell carcinomas (RCC). The main complications of partial nephrectomy, especially for large and centrally located tumors, are urinary leakage and parenchymal bleeding. We prospectively evaluated the pros and cons of using porcine small intestinal submucosa (SIS, Surgisis®) to close the renal defect after nephron-sparing surgery.
  
  
  METHODS
  We used Surgisis® (Cook medical, Bloomington, IN, USA) to secure and compress the capsular defect after tumor resection in 123 patients submitted to 129 partial nephrectomies between August 2003 and February 2011.
  
  
  RESULTS
  The median tumor size was 3.7 cm (range 1.1-13.0 cm). Procedures were performed with cold ischemia in 24 cases (18.2%), with warm ischemia in 46 (35.6%), and without ischemia in 59 cases (44.8%). In the total group of patients, 4 (3.1%) developed urinary fistula, and only 2 (1.6%) required postoperative transfusions due to hemorrhage after the application of the small intestinal submucosa membrane.
  
  
  CONCLUSIONS
  Small intestinal submucosa is an easy-to-use biomaterial for preventing complications such as postoperative bleeding and urinary fistula in nephron-sparing surgery, especially in cases where tumor excision causes significant renal capsular and/or renal pelvic defects.
authors: Department of Urology, Ulm University Medical Center, Prittwitzstrasse 43, D-89075 Ulm, Germany.
authors: Thomas J
authors: TJ
authors: Schnoeller
authors: Robert
authors: R
authors: de Petriconi
authors: Robert
authors: R
authors: Hefty
authors: Florian
authors: F
authors: Jentzmik
authors: Sandra
authors: S
authors: Waalkes
authors: Friedemann
authors: F
authors: Zengerling
authors: Mark
authors: M
authors: Schrader
authors: Andres J
authors: AJ
authors: Schrader
mesh_terms: D000818:Animals; D001684:Biological Dressings; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D006801:Humans; D007413:Intestinal Mucosa; D007421:Intestine, Small; D007680:Kidney Neoplasms / Q000601:surgery*; D009392:Nephrectomy; D011446:Prospective Studies; D013552:Swine; D014481:United States; D052096:Warm Ischemia