Evaluation of a hemostatic sponge (TachoSil®) for sealing of the renal collecting system in a porcine laparoscopic partial nephrectomy survival model

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dc.contributor.authorRane A.
dc.contributor.authorRimington P.D.
dc.contributor.authorHeyns C.F.
dc.contributor.authorVan Der Merwe A.
dc.contributor.authorSmit S.
dc.contributor.authorAnderson C.
dc.date.accessioned2011-05-15T16:16:58Z
dc.date.available2011-05-15T16:16:58Z
dc.date.issued2010
dc.description.abstractObjective: The objective of this study was to evaluate the efficacy of TachoSil® (Nycomed UK, Oxford, Buckinghamshire, UK), a hemostatic sponge, to seal major collecting system injuries (in addition to providing an adjunct to hemostasis) after partial nephrectomy in a porcine chronic survival model. Materials and Methods: Laparoscopic upper-pole partial nephrectomies were performed in 10 farm pigs (>40kg). After hilar clamping, an energyless incision was made at a point halfway between the hilum and the upper pole of the kidney and the collecting system was opened widely. TachoSil was applied to cover the defect; 15 to 20 minutes after the application of TachoSil, the hilar clamp was removed, hemostasis confirmed, and the pig survived. Assessment was made for hematoma and urinoma. Four weeks postoperatively, the pigs were euthanized. Ex-vivo retrograde studies were performed to assess collecting system leak. Weight, blood pressure, estimated blood loss, the weight of the partial and completion nephrectomy specimen, presence/absence of urinary leak on retrograde study, histopathologic findings, and complications were recorded. Results: All pigs survived. Mean warm ischemia time was 18 minutes, mean blood loss was 90mL, and mean resected weight was 13.7g. There was no evidence of leak on retrograde study. Histologically, nonspecific changes were noted in all specimens, which included dystrophic calcification, scarring, and areas of fibrosis at the partial nephrectomy surgical margin. Conclusion: TachoSil seals the collecting system after partial nephrectomy on a porcine chronic survival model, in addition to providing an adjunct to hemostasis. More studies, including human trials, are warranted to evaluate this observation further. © Copyright 2010, Mary Ann Liebert, Inc..
dc.description.versionArticle
dc.identifier.citationJournal of Endourology
dc.identifier.citation24
dc.identifier.citation4
dc.identifier.issn08927790
dc.identifier.other10.1089/end.2009.0453
dc.identifier.urihttp://hdl.handle.net/10019.1/14015
dc.subjectcreatinine
dc.subjecthemoglobin
dc.subjecturea
dc.subjectanimal experiment
dc.subjectanimal model
dc.subjectarticle
dc.subjectbleeding
dc.subjectbody mass
dc.subjectcalcinosis
dc.subjectcreatinine blood level
dc.subjectdiastolic blood pressure
dc.subjectex vivo study
dc.subjectfibrosis
dc.subjecthemoglobin blood level
dc.subjecthemostasis
dc.subjecthemostatic sponge
dc.subjecthistopathology
dc.subjectkidney collecting tubule
dc.subjectkidney mass
dc.subjectkidney tubule damage
dc.subjectnonhuman
dc.subjectpartial nephrectomy
dc.subjectperitoneal fluid
dc.subjectporcine laparoscopic partial nephrectomy
dc.subjectpriority journal
dc.subjectradiodiagnosis
dc.subjectscar formation
dc.subjectseal
dc.subjectsurgical approach
dc.subjectsurgical sponge
dc.subjectsurgical technique
dc.subjectsystolic blood pressure
dc.subjecttreatment outcome
dc.subjecturea blood level
dc.subjectAnimals
dc.subjectCreatinine
dc.subjectDrug Combinations
dc.subjectFibrinogen
dc.subjectHemoglobins
dc.subjectHemostasis, Surgical
dc.subjectHemostatics
dc.subjectKidney Tubules, Collecting
dc.subjectLaparoscopy
dc.subjectModels, Animal
dc.subjectNephrectomy
dc.subjectSurgical Sponges
dc.subjectSurvival Analysis
dc.subjectSus scrofa
dc.subjectThrombin
dc.subjectUrography
dc.titleEvaluation of a hemostatic sponge (TachoSil®) for sealing of the renal collecting system in a porcine laparoscopic partial nephrectomy survival model
dc.typeArticle
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