title: Use of self-retaining barbed sutures decreases cold ischemia time in open nephron-sparing surgery.
abstract: OBJECTIVE
  In the present study, we aimed to determine whether the use of self-retaining barbed sutures (SRBS) instead of conventional sutures during open partial nephrectomy leads to improved surgical outcomes.
  
  
  METHODS
  A retrospective analysis of 50 consecutive patients who underwent open partial nephrectomy for a unicentric renal tumor was performed. In 15 patients, SRBS were used for parenchymal repair during open partial nephrectomy, and in 35 patients, conventional sutures were used. The parameters related to surgical outcomes were recorded and analysis of the total patient population and subgroup analysis according to the preoperative aspects and dimensions used for an anatomical (PADUA) score classification was performed.
  
  
  RESULTS
  The preoperative baseline values did not statistically differ between the groups. Analysis of the total patient population showed a significant difference regarding ischemia time (mean  ±  standard deviation) between the SRBS group (15.2 ± 6.9 min), and the conventional suture group (25.7 ± 11.8 min). There was no significant difference between the barbed and conventional sutures with regard to postoperative hemoglobin levels, decline in hemoglobin percentage, or renal function parameters. In subgroup-analysis, a significant difference in ischemia time was only found for PADUA scores 6 and 7, without any effect on the outcome parameters.
  
  
  CONCLUSIONS
  The use of SRBS in parenchymal repair during open partial nephrectomy appears to be a safe and feasible option with decreased cold ischemia time when compared with conventional sutures. In PADUA subgroup-analysis this difference was only observed for PADUA scores 6 and 7.
authors.affiliation: Department of Urology, Kaiser-Franz-Josef-Hospital, Vienna, Austria.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Schauer
authors.forename: Oliver
authors.initials: O
authors.lastname: Theimer
authors.forename: Tobias
authors.initials: T
authors.lastname: Klatte
authors.forename: Matthias
authors.initials: M
authors.lastname: Waldert
authors.forename: Hans-Christoph
authors.initials: HC
authors.lastname: Klingler
authors.forename: Markus
authors.initials: M
authors.lastname: Margreiter
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050377:Cold Ischemia / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000295:instrumentation*; D061646:Operative Time; D059351:Organ Sparing Treatments / Q000295:instrumentation* / Q000379:methods*; D012189:Retrospective Studies; D013536:Suture Techniques / Q000295:instrumentation*; D013537:Sutures; D016896:Treatment Outcome