title: Initial experiences with the Hemopatch® as a hemostatic agent in zero-ischemia partial nephrectomy.
abstract: OBJECTIVE
  Nephron-sparing surgery (NSS) is the gold standard treatment for resectable renal tumors. In the last decade, laparoscopic partial nephrectomy (LPN) has evolved in technical, surgical and oncological aspects and is an accepted treatment option for local-stage renal tumors. Improvements in not only surgical techniques, but also potent hemostats have encouraged this evolution. Here, we report our initial experiences with a new hemostatic agent, Hemopatch(®) (polyethylene glycol-coated collagen patch, Baxter), in zero-ischemia LPN.
  
  
  METHODS
  Seven patients with confirmed renal masses were enrolled and subjected to zero-ischemia LPN. In all cases, Hemopatch(®) was applied to the tumor resection site after suturing of the renal parenchyma. The following clinical data were captured for analysis: staging information, PADUA and RENAL nephrometry scores, operation time, blood loss, complications, pathology and hospitalization length.
  
  
  RESULTS
  The median tumor size was 30.0 mm (range 9.5-72). The median PADUA and RENAL nephrometry scores were 6 (range 6-7) and 4 (range 4-6), respectively. All LPNs were performed with the zero-ischemia technique. In six of the seven patients, parenchymal suturing of the resection site was performed. No uncontrolled bleeding was observed. The median operation duration was 139 min (range 103-194), the median blood loss was 325 cc (range 50-700) and the median hospitalization length was 6 days (range 4-7). Hemopatch(®) provided sufficient hemostasis in all cases. No postoperative complications were observed.
  
  
  CONCLUSIONS
  Although this study is limited to a small set of initial experiences with Hemopatch(®) in LPN, it proves the feasibility and reliability of this new hemostat. Following further evaluation in prospective randomized comparative studies, Hemopatch(®) might represent a promising tool in NSS.
authors.affiliation: Clinic for Urology and Urologic Oncology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany. Imkamp.florian@mh-hannover.de.
authors.forename: F
authors.initials: F
authors.lastname: Imkamp
authors.affiliation: Clinic for Urology and Urologic Oncology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany. Tolkach.iurii@mh-hannover.de.
authors.forename: Y
authors.initials: Y
authors.lastname: Tolkach
authors.affiliation: Clinic for Urology and Urologic Oncology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany. wolters.mathias@mh-hannover.de.
authors.forename: M
authors.initials: M
authors.lastname: Wolters
authors.affiliation: Clinic for Urology and Urologic Oncology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany. jutzi.stephan@mh-hannover.de.
authors.forename: S
authors.initials: S
authors.lastname: Jutzi
authors.affiliation: Clinic for Urology and Urologic Oncology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany. Kramer.mario@mh-hannover.de.
authors.forename: M
authors.initials: M
authors.lastname: Kramer
authors.affiliation: Clinic for Urology and Urologic Oncology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany. herrmann.thomas@mh-hannover.de.
authors.forename: T
authors.initials: T
authors.lastname: Herrmann
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D006489:Hemostatic Techniques; D006490:Hemostatics / Q000008:administration & dosage*; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000628:therapy*; D011446:Prospective Studies; D015203:Reproducibility of Results; D016896:Treatment Outcome; D047368:Tumor Burden
chemical_list: D006490:Hemostatics
keywords: Hemopatch; Hemostasis; Laparoscopic; Partial nephrectomy; Renal cancer