title: [Clinical comparison between microporous polysaccharide hemispheres (MPH) and fibrin glue].
abstract: OBJECTIVE
  Nephron-sparing surgery for small renal tumors has gained acceptance in an attempt to preserve renal function while achieving a level of cancer control equivalent to that obtained by radical nephrectomy. Moreover, laparoscopic partial nephrectomy (LPN) has been applied to partial nephrectomy because of it is less invasive. However, LPN is a technically complex procedure and has more potential for complications than open partial nephrectomy (OPN). Using hemostatic agents is one of the options to avoid complications during LPN. Microporous polysaccharide hemispheres (MPH) are an absorbable hemostatic powder produced from purified potato starch. We compare the efficacy of this new hemostatic agent, MPH and the standard hemostatic agent, fibrin glue.
  
  
  METHODS
  Between January 2007 and March 2011, 55 LPNs for suspected malignancy were completed by a single surgeon in Yokohama City University Hospital. We compare two sequential groups of patients: group A consisted of 12 patients in whom MPH was used (age 41-77, mean age 59.7, male: female = 10 : 2) and group B consisted of 43 patients in whom fibrin glue was used (age 22-79, mean age 60.3, male: female = 31 : 12), retrospectively. These agents (MPH and fibrin glue) were applied to the partial nephrectomy bed before tying a suture in parenchymal suturing and after the renal hilum was unclamped.
  
  
  RESULTS
  The MPH group showed significantly less mean estimated blood loss (25.6 vs. 86.3 ml; p = 0.036). There was no significant difference in surgical duration, ischemic time or urine leakage. Postoperative complications occurred in two patients in group B, but there were no postoperative complications in group A.
  
  
  CONCLUSIONS
  MPH is available as an adequate hemostatic agent during LPN. There was no significant difference in the incidence of postoperative complications between MPH and fibrin glue.
authors.affiliation: Department of Urology, Yokohama City University Graduate School of Medicine.
authors.forename: Ryoko
authors.initials: R
authors.lastname: Sakata
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Makiyama
authors.forename: Go
authors.initials: G
authors.lastname: Noguchi
authors.forename: Futoshi
authors.initials: F
authors.lastname: Sano
authors.forename: Noboru
authors.initials: N
authors.lastname: Nakaigawa
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yao
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Kubota
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D015718:Fibrin Tissue Adhesive; D016558:Hemostasis, Endoscopic / Q000379:methods*; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D011134:Polysaccharides; D016062:Porosity; D012189:Retrospective Studies
chemical_list: D015718:Fibrin Tissue Adhesive; D011134:Polysaccharides