title: The use of bovine serum albumin-glutaraldehyde tissue adhesive (BioGlue®) for tumor bed closure following open partial nephrectomy.
abstract: OBJECTIVE
  To report the results of the use of Bovine Serum Albumin-Glutaraldehyde tissue adhesive (BioGlue®) for tumor bed closure in open nephron-sparing surgery (NSS).
  
  
  METHODS
  The cohort included 255 patients with enhancing renal mass who underwent open NSS. We used open flank approach, with in-situ hypothermia and enucleation of the tumor. For tumor bed closure, we used the BioGlue®sealant for tumor bed filling, without suturing the edges.
  
  
  RESULTS
  Mean patients' age was 65.4 years. 5.1% of patients had pre-operative chronic renal failure. Mean renal mass diameter was 4.2±1.6cm and mean R.E.N.A.L nephrometry score was 8.0±1.6. Mean ischemia time was 21.8±7.6. Mean estimated blood loss was 42±82ml and only two patients required blood transfusion. Urine leak and pseudo-aneurysm were recorded in two and one patient, respectively. None of the operations were converted to radical nephrectomy. The average change between post-operative and pre-operative eGFR (Δ=-1.7ml/min) was insignificant in a mean follow-up of 30.1±29.6 months. The 10-year recurrence-free survival rate was 99% and the 10-year overall survival rate was 85%.
  
  
  CONCLUSIONS
  The use of BioGlue®alone for hemostasis after NSS is a feasible and safe alternative to classical suturing. Its use enables satisfactory functional outcome and could potentially reduce ischemia time.
authors.affiliation: Bnai-Zion Medical Center, Faculty of Medicine, Technion-Institute of Technology, Haifa, Israel. Electronic address: Zaher.bahouth@b-zion.org.il.
authors.forename: Z
authors.initials: Z
authors.lastname: Bahouth
authors.affiliation: Bnai-Zion Medical Center, Faculty of Medicine, Technion-Institute of Technology, Haifa, Israel.
authors.forename: S
authors.initials: S
authors.lastname: Halachmi
authors.affiliation: Bnai-Zion Medical Center, Faculty of Medicine, Technion-Institute of Technology, Haifa, Israel.
authors.forename: S
authors.initials: S
authors.lastname: Shprits
authors.affiliation: Bnai-Zion Medical Center, Faculty of Medicine, Technion-Institute of Technology, Haifa, Israel.
authors.forename: Y
authors.initials: Y
authors.lastname: Burbara
authors.affiliation: Bnai-Zion Medical Center, Faculty of Medicine, Technion-Institute of Technology, Haifa, Israel.
authors.forename: O
authors.initials: O
authors.lastname: Avitan
authors.affiliation: Bnai-Zion Medical Center, Faculty of Medicine, Technion-Institute of Technology, Haifa, Israel.
authors.forename: I
authors.initials: I
authors.lastname: Masarwa
authors.affiliation: Bnai-Zion Medical Center, Faculty of Medicine, Technion-Institute of Technology, Haifa, Israel.
authors.forename: B
authors.initials: B
authors.lastname: Moskovitz
authors.affiliation: Bnai-Zion Medical Center, Faculty of Medicine, Technion-Institute of Technology, Haifa, Israel.
authors.forename: O
authors.initials: O
authors.lastname: Nativ
mesh_terms: D000368:Aged; D000818:Animals; D002417:Cattle; D018572:Disease-Free Survival; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D005976:Glutaral / Q000627:therapeutic use; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D007036:Hypothermia, Induced; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D059351:Organ Sparing Treatments / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology; D011506:Proteins / Q000627:therapeutic use*; D051381:Rats; D012189:Retrospective Studies; D012710:Serum Albumin, Bovine / Q000627:therapeutic use; D014014:Tissue Adhesives / Q000627:therapeutic use*; D058106:Wound Closure Techniques
chemical_list: C472676:Bio-glue; D011506:Proteins; D014014:Tissue Adhesives; D012710:Serum Albumin, Bovine; D005976:Glutaral
keywords: BioGlue; Cirugía preservadora de nefronas; Enucleation; Glomerular filtration rate; Nephron-sparing surgery; Sellador de tejidos; Tasa de filtración glomerular; Tissue sealant; enucleación