title: Use of a polytetrafluoroethylene (GORE-TEX) bolster to close the renal parenchymal defect during open partial nephrectomy.
abstract: BACKGROUND
  Numerous surgical techniques have been described to facilitate closure of the renal parenchymal defect. We sought to describe the operative technique and define the safety and efficacy of using an expanded polytetrafluoroethylene (GORE-TEX; WL Gore and Associates, Flagstaff, AZ) bolster to aid in closure of the renal parenchymal defect at the time of open partial nephrectomy (OPN).
  
  
  METHODS
  A retrospective review of 175 patients who underwent an OPN using an expanded polytetrafluoroethylene (ePTFE) bolster at the Huntsman Cancer Hospital, University of Utah and Salt Lake City Veterans Affairs Medical Center from March 2005 to February 2013 was conducted. Postoperative complications occurring within 90 days were graded using the Clavien grading system.
  
  
  CONCLUSIONS
  Overall, 57 patients (32.6%) experienced a postoperative complication. Fifteen patients (8.5%) had a Clavien ≥ grade-III complication. Ten patients (5.7%) received blood transfusions. Urine leak requiring intervention occurred in 2 patients (1.1%). Delayed hemorrhage requiring nephrectomy and pseudoaneurysm formation were rare, occurring in 1 patient each (0.6%). Infection of the ePTFE material occurred in 2 patients (1.1%). In both cases, it was explanted without requiring nephrectomy. The use of an ePTFE bolster is an effective and safe method of closing the renal parenchymal defect after OPN with an acceptable 90-day postoperative complication rate and a low risk of infection.
authors.affiliation: Huntsman Cancer Institute, Division of Urology, University of Utah School of Medicine, Salt Lake City, UT.
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Redshaw
authors.affiliation: Huntsman Cancer Institute, Division of Urology, University of Utah School of Medicine, Salt Lake City, UT.
authors.forename: Jeremy M
authors.initials: JM
authors.lastname: West
authors.affiliation: Huntsman Cancer Institute, Division of Urology, University of Utah School of Medicine, Salt Lake City, UT.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Stephenson
authors.affiliation: Huntsman Cancer Institute, Division of Urology, University of Utah School of Medicine, Salt Lake City, UT.
authors.forename: William T
authors.initials: WT
authors.lastname: Lowrance
authors.affiliation: Huntsman Cancer Institute, Division of Urology, University of Utah School of Medicine, Salt Lake City, UT.
authors.forename: Blake D
authors.initials: BD
authors.lastname: Hamilton
authors.affiliation: Huntsman Cancer Institute, Division of Urology, University of Utah School of Medicine, Salt Lake City, UT.
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Southwick
authors.affiliation: Huntsman Cancer Institute, Division of Urology, University of Utah School of Medicine, Salt Lake City, UT. Electronic address: christopher.dechet@hci.utah.edu.
authors.forename: Christopher B
authors.initials: CB
authors.lastname: Dechet
mesh_terms: D020341:Absorbable Implants; D000368:Aged; D017541:Aneurysm, False; D005260:Female; D006801:Humans; D007668:Kidney / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D011138:Polytetrafluoroethylene / Q000737:chemistry*; D011183:Postoperative Complications; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative; D013537:Sutures; D016896:Treatment Outcome
chemical_list: D011138:Polytetrafluoroethylene