title: Use of biological Glue (Bioglue®) in laparoscopic partial nephrectomy: a study in pigs.
abstract: BACKGROUND
  Partial nephrectomy is the standard of care for localized renal tumors. However, bleeding and warm ischemia time are still controversial when laparoscopic surgeries are carried out. Herein, we aim to compare the outcomes from laparoscopic partial nephrectomy with and without the use of biological glue with purified bovine albumin and glutaraldehyde (BioGlue ®).
  
  
  METHODS
  Twenty-four kidneys of 12 pigs were used in this study. A pre-determined lower pole segment was resected (3 cm x 1 cm) and one of two different hemostatic techniques was performed. In one kidney, hemostatic ″ U suture ″ (poliglecaprone 3.0) was performed and in the contra-lateral kidney, only the biological glue was applied. Data recorded was comprised of warm ischemia time (seconds) and estimated blood loss (mL) for each procedure. In cases of bleeding after glue administration, a complementary suture was done.
  
  
  RESULTS
  Mean warm ischemia time was 492.9 ± 113.1 (351-665) seconds and 746 ± 185.3 (409-1125) seconds for biological glue and suture groups, respectively. There was a positive significant difference in terms of warm ischemia favoring the biological glue group over the suture group (p<0.001). Mean blood loss was 39.4 (0-115) mL for the biological glue group and 39.1 (5-120) mL for the suture group (p=0.62).
  
  
  CONCLUSIONS
  Biological glue is an important tool for laparoscopic partial nephrectomies. It is effective for hemostatic control in selected cases, and it can be used in combination with the traditional suture techniques.
authors.affiliation: Instituto de Ensino e Pesquisa do Hospital Sirio Libanês, São Paulo, SP, Brazil.
authors.forename: Luis Felipe
authors.initials: LF
authors.lastname: Brandão
authors.affiliation: Division of Urology, Hospital das Clinicas, University of São Paulo Medical School - São Paulo, SP, Brazil.
authors.forename: Fabio Cesar Miranda
authors.initials: FC
authors.lastname: Torricelli
authors.affiliation: Instituto de Ensino e Pesquisa do Hospital Sirio Libanês, São Paulo, SP, Brazil.
authors.forename: Glauco
authors.initials: G
authors.lastname: Melo
authors.affiliation: Instituto de Ensino e Pesquisa do Hospital Sirio Libanês, São Paulo, SP, Brazil.
authors.forename: Luiz Cesar Fernando
authors.initials: LC
authors.lastname: Takano
authors.affiliation: Instituto de Ensino e Pesquisa do Hospital Sirio Libanês, São Paulo, SP, Brazil.|Division of Urology, Hospital das Clinicas, University of São Paulo Medical School - São Paulo, SP, Brazil.
authors.forename: Anuar Ibrahim
authors.initials: AI
authors.lastname: Mitre
authors.affiliation: Instituto de Ensino e Pesquisa do Hospital Sirio Libanês, São Paulo, SP, Brazil.|Division of Urology, Hospital das Clinicas, University of São Paulo Medical School - São Paulo, SP, Brazil.
authors.forename: Marco Antonio
authors.initials: MA
authors.lastname: Arap
mesh_terms: D000818:Animals; D016063:Blood Loss, Surgical; D005976:Glutaral / Q000627:therapeutic use*; D007668:Kidney / Q000098:blood supply / Q000601:surgery*; D007680:Kidney Neoplasms / Q000601:surgery; D010535:Laparoscopy / Q000379:methods*; D008488:Medical Illustration; D023421:Models, Animal; D009392:Nephrectomy / Q000379:methods*; D011506:Proteins / Q000627:therapeutic use*; D012016:Reference Values; D015203:Reproducibility of Results; D012709:Serum Albumin / Q000627:therapeutic use; D013536:Suture Techniques; D013552:Swine; D013997:Time Factors; D016896:Treatment Outcome; D052096:Warm Ischemia / Q000379:methods
chemical_list: C472676:Bio-glue; D011506:Proteins; D012709:Serum Albumin; D005976:Glutaral