title: Bleeding during laparoscopic partial nephrectomy: Can a hemostatic matrix help to improve hemostasis?
abstract: To evaluate the possible role of an hemostatic matrix on hemostasis, perioperative outcomes and complications in patients who underwent laparoscopic partial nephrectomy (LPN).
  
  
  
  Patients charts were analyzed retrospectively and their demographic characteristics, operative parameters and follow-up results were recorded. Patients were divided into two groups, according to those who used an hemostatic matrix as Group 1 (n = 41) and those who did not used as Group 2 (n = 44). Demographic characteristics of patients, tumor features, operation time, clamping of the renal vessels, ischemia time, suturing of the collecting system, perioperative hemorrhage and complications were evaluated. Histopathological results, surgical margin status, creatinine level and recurrence at the 3rd month of follow up were analyzed. Statistical analyses were performed with SPSS 17.0 and significance was set at p value of < 0.05.
  
  
  
  The mean RENAL nephrometry score was 5.9 ± 2.0 and the mean tumor size was 35 ± 12 mm. All patients had a single tumor and 44 of them had a tumor in the right kidney. The renal artery was clamped in 79 cases and the mean ischemia time was 20.1 ± 7 minutes. The mean tumor size and the mean RENAL nephrometry score was statistically higher in Group 1 (p: 0.016 and p < 0.001, respectively). Pelvicaliceal repair was more common in Group 1 due to deeper extension of tumors in this group (p: 0.038). In Group 1, less hemorrhage and blood transfusion requirement, with shorter ischemia and operation time was detected.
  
  
  
  The outcomes of the recent study showed that adjunctive use of an hemostatic matrix improves hemostasis and decreases hemorrhagic complications during LPN. Further prospective studies are required to assess the potential role of an hemostatic matrix in LPN.
authors.affiliation: Department of Urology, Haseki Teaching and Research Hospital, Istanbul. md.farukozgor@yahoo.com.
authors.forename: Faruk
authors.initials: F
authors.lastname: Ozgor
authors.forename: Abdulmuttalip
authors.initials: A
authors.lastname: Simsek
authors.forename: Ozgu
authors.initials: O
authors.lastname: Aydogdu
authors.forename: Onur
authors.initials: O
authors.lastname: Kucuktopcu
authors.forename: Omer
authors.initials: O
authors.lastname: Sarilar
authors.forename: Ahmet Yalcin
authors.initials: AY
authors.lastname: Berberoglu
authors.forename: Mehmet Fatih
authors.initials: MF
authors.lastname: Akbulut
authors.forename: Murat
authors.initials: M
authors.lastname: Binbay
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D005781:Gelatin Sponge, Absorbable / Q000008:administration & dosage; D006490:Hemostatics / Q000008:administration & dosage*; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009392:Nephrectomy / Q000379:methods*; D061646:Operative Time; D012077:Renal Artery; D012189:Retrospective Studies
chemical_list: C411004:FloSeal Matrix; D006490:Hemostatics