title: TriMatch comparison of the efficacy of FloSeal versus TachoSil versus no hemostatic agents for partial nephrectomy: results from a large multicenter dataset.
abstract: OBJECTIVE
  To evaluate the efficacy of hemostatic agents, TachoSil and FloSeal, during partial nephrectomy using a large multicenter dataset.
  
  
  METHODS
  Data of 1055 patients who underwent partial nephrectomy between January 2009 and December 2012 in 19 Italian centers were collected within an observational multicentric study (RECORd Project). The decision whether or not to use hemostatic agents after renorrhaphy and the type of hemostatic agents applied was adopted according to the centers' and surgeons' preference. A TriMatch propensity score analysis was applied to balance three study groups (no hemostatic agents, TachoSil, FloSeal) for sex, age, surgical indication (elective/relative vs imperative), clinical stage (cT1a vs cT1b), tumor exophyticity, approach (open vs minimally invasive), technique (standard partial nephrectomy vs simple enucleation), preoperative hemoglobin and creatinine. Postoperative complications and variation of hemoglobin and creatinine values between preoperative versus third postoperative day were compared.
  
  
  RESULTS
  TriMatch analysis allowed us to obtain 66 well-balanced triplets. No differences were found in terms of outcomes between the study groups.
  
  
  CONCLUSIONS
  The present findings suggest that adding hemostatic agents to renorraphy during partial nephrectomy does not provide better surgical outcomes.
authors.affiliation: Department of Urology, University of Brescia, Brescia, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Antonelli
authors.forename: Andrea
authors.initials: A
authors.lastname: Minervini
authors.forename: Andrea
authors.initials: A
authors.lastname: Mari
authors.forename: Riccardo
authors.initials: R
authors.lastname: Bertolo
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Bianchi
authors.forename: Alberto
authors.initials: A
authors.lastname: Lapini
authors.forename: Nicola
authors.initials: N
authors.lastname: Longo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Martorana
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Mirone
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Morgia
authors.forename: Giacomo
authors.initials: G
authors.lastname: Novara
authors.forename: Francesco
authors.initials: F
authors.lastname: Porpiglia
authors.forename: Bernardo
authors.initials: B
authors.lastname: Rocco
authors.forename: Bruno
authors.initials: B
authors.lastname: Rovereto
authors.forename: Riccardo
authors.initials: R
authors.lastname: Schiavina
authors.forename: Claudio
authors.initials: C
authors.lastname: Simeone
authors.forename: Mario
authors.initials: M
authors.lastname: Sodano
authors.forename: Carlo
authors.initials: C
authors.lastname: Terrone
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Ficarra
authors.forename: Marco
authors.initials: M
authors.lastname: Carini
authors.forename: Sergio
authors.initials: S
authors.lastname: Serni
mesh_terms: D000328:Adult; D000368:Aged; D004338:Drug Combinations; D005260:Female; D005340:Fibrinogen / Q000627:therapeutic use*; D005781:Gelatin Sponge, Absorbable / Q000627:therapeutic use*; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications; D057216:Propensity Score; D011446:Prospective Studies; D013917:Thrombin / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D004338:Drug Combinations; C411004:FloSeal Matrix; D006490:Hemostatics; C518955:TachoSil; D005340:Fibrinogen; D013917:Thrombin
keywords: bleeding; complications; hemostasis; hemostatic agent; partial nephrectomy