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World Journal of Surgical Oncology

, 9:126

First Online: 12 October 2011Received: 25 May 2011Accepted: 12 October 2011

Abstract

BackgroundWhenever technically feasible and oncologically justified, nephron-sparing surgery is the current standard of care for localized renal cell carcinomas RCC. The main complications of partial nephrectomy, especially for large and centrally located tumors, are urinary leakage and parenchymal bleeding. We prospectively evaluated the pros and cons of using porcine small intestinal submucosa SIS, Surgisis to close the renal defect after nephron-sparing surgery.

MethodsWe used Surgisis Cook medical, Bloomington, IN, USA to secure and compress the capsular defect after tumor resection in 123 patients submitted to 129 partial nephrectomies between August 2003 and February 2011.

ResultsThe median tumor size was 3.7 cm range 1.1-13.0 cm. Procedures were performed with cold ischemia in 24 cases 18.2%, with warm ischemia in 46 35.6%, and without ischemia in 59 cases 44.8%. In the total group of patients, 4 3.1% developed urinary fistula, and only 2 1.6% required postoperative transfusions due to hemorrhage after the application of the small intestinal submucosa membrane.

ConclusionSmall intestinal submucosa is an easy-to-use biomaterial for preventing complications such as postoperative bleeding and urinary fistula in nephron-sparing surgery, especially in cases where tumor excision causes significant renal capsular and-or renal pelvic defects.

Keywordsrenal cell carcinoma nephron-sparing surgery urinoma postoperative hemorrhage complications Electronic supplementary materialThe online version of this article doi:10.1186-1477-7819-9-126 contains supplementary material, which is available to authorized users.

Thomas J Schnoeller, Robert de Petriconi contributed equally to this work.

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Autor: Thomas J Schnoeller - Robert de Petriconi - Robert Hefty - Florian Jentzmik - Sandra Waalkes - Friedemann Zengerling - Mark

Fuente: https://link.springer.com/



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