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Erschienen in: Wiener klinische Wochenschrift 11-12/2014

01.06.2014 | original article

Use of self-retaining barbed sutures decreases cold ischemia time in open nephron-sparing surgery

verfasst von: MD Ingrid Schauer, Oliver Theimer, MD Tobias Klatte, MD Matthias Waldert, MD Hans-Christoph Klingler, MD Markus Margreiter

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 11-12/2014

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Summary

Purpose

In the present study, we aimed to determine whether the use of self-retaining barbed sutures (SRBS) instead of conventional sutures during open partial nephrectomy leads to improved surgical outcomes.

Patients, Materials and Methods

A retrospective analysis of 50 consecutive patients who underwent open partial nephrectomy for a unicentric renal tumor was performed. In 15 patients, SRBS were used for parenchymal repair during open partial nephrectomy, and in 35 patients, conventional sutures were used. The parameters related to surgical outcomes were recorded and analysis of the total patient population and subgroup analysis according to the preoperative aspects and dimensions used for an anatomical (PADUA) score classification was performed.

Results

The preoperative baseline values did not statistically differ between the groups. Analysis of the total patient population showed a significant difference regarding ischemia time (mean  ±  standard deviation) between the SRBS group (15.2 ± 6.9 min), and the conventional suture group (25.7 ± 11.8 min). There was no significant difference between the barbed and conventional sutures with regard to postoperative hemoglobin levels, decline in hemoglobin percentage, or renal function parameters. In subgroup-analysis, a significant difference in ischemia time was only found for PADUA scores 6 and 7, without any effect on the outcome parameters.

Conclusions

The use of SRBS in parenchymal repair during open partial nephrectomy appears to be a safe and feasible option with decreased cold ischemia time when compared with conventional sutures. In PADUA subgroup-analysis this difference was only observed for PADUA scores 6 and 7.
Literatur
1.
Zurück zum Zitat Ljungberg B, Cowan NC, Hanbury DC, et al. EAU guidelines on renal cell carcinoma: the 2010 update. Eur Urol. 2010;58:398–406. PubMedCrossRef Ljungberg B, Cowan NC, Hanbury DC, et al. EAU guidelines on renal cell carcinoma: the 2010 update. Eur Urol. 2010;58:398–406. PubMedCrossRef
2.
Zurück zum Zitat Go AS, Chertow GM, Fan D, et al. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;351:1296–305. PubMedCrossRef Go AS, Chertow GM, Fan D, et al. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;351:1296–305. PubMedCrossRef
3.
Zurück zum Zitat Huang WC, Levey AS, Serio AM, et al. Chronic kidney disease after nephrectomy in patients with renal cortical tumours: a retrospective cohort study. Lancet Oncol. 2006;7:735–40. PubMedCentralPubMedCrossRef Huang WC, Levey AS, Serio AM, et al. Chronic kidney disease after nephrectomy in patients with renal cortical tumours: a retrospective cohort study. Lancet Oncol. 2006;7:735–40. PubMedCentralPubMedCrossRef
4.
Zurück zum Zitat McKiernan J, Simmons R, Katz J, et al. Natural history of chronic renal insufficiency after partial and radical nephrectomy. Urology. 2002;59:816–20. PubMedCrossRef McKiernan J, Simmons R, Katz J, et al. Natural history of chronic renal insufficiency after partial and radical nephrectomy. Urology. 2002;59:816–20. PubMedCrossRef
5.
Zurück zum Zitat Miller DC, Schonlau M, Litwin MS, et al. Renal and cardiovascular morbidity after partial or radical nephrectomy. Cancer. 2008;112:511–20. PubMedCrossRef Miller DC, Schonlau M, Litwin MS, et al. Renal and cardiovascular morbidity after partial or radical nephrectomy. Cancer. 2008;112:511–20. PubMedCrossRef
6.
Zurück zum Zitat Thompson RH, Boorjian SA, Lohse CM, et al. Radical nephrectomy for pT1a renal masses may be associated with decreased overall survival compared with partial nephrectomy. J Urol. 2008;179:468–71. PubMedCrossRef Thompson RH, Boorjian SA, Lohse CM, et al. Radical nephrectomy for pT1a renal masses may be associated with decreased overall survival compared with partial nephrectomy. J Urol. 2008;179:468–71. PubMedCrossRef
7.
Zurück zum Zitat MacLennan S, Imamura M, Lapitan MC, et al. Systematic review of oncological outcomes following surgical management of localised renal cancer. Eur Urol. 2012;61:972–93. PubMedCrossRef MacLennan S, Imamura M, Lapitan MC, et al. Systematic review of oncological outcomes following surgical management of localised renal cancer. Eur Urol. 2012;61:972–93. PubMedCrossRef
8.
Zurück zum Zitat Becker F, Van Poppel H, Hakenberg OW, et al. Assessing the impact of ischaemia time during partial nephrectomy. Eur Urol. 2009;56:625–34. PubMedCrossRef Becker F, Van Poppel H, Hakenberg OW, et al. Assessing the impact of ischaemia time during partial nephrectomy. Eur Urol. 2009;56:625–34. PubMedCrossRef
9.
Zurück zum Zitat Marszalek M, Ponholzer A, BrÓ§ssner C, et al. Elective open nephron-sparing surgery for renal masses: single-center experience with 129 consecutive patients. Urology. 2004;64:38–42. PubMedCrossRef Marszalek M, Ponholzer A, BrÓ§ssner C, et al. Elective open nephron-sparing surgery for renal masses: single-center experience with 129 consecutive patients. Urology. 2004;64:38–42. PubMedCrossRef
10.
Zurück zum Zitat Charlson ME, Pompei P, Ales KL, et al. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–83. PubMedCrossRef Charlson ME, Pompei P, Ales KL, et al. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–83. PubMedCrossRef
11.
Zurück zum Zitat Ficarra V, Novara G, Secco S, et al. Preoperative aspects and dimensions used for an anatomical (PADUA) classification of renal tumours in patients who are candidates for nephron-sparing surgery. Eur Urol. 2009;56:786–93. PubMedCrossRef Ficarra V, Novara G, Secco S, et al. Preoperative aspects and dimensions used for an anatomical (PADUA) classification of renal tumours in patients who are candidates for nephron-sparing surgery. Eur Urol. 2009;56:786–93. PubMedCrossRef
12.
Zurück zum Zitat Michels WM, Grootendorst DC, Verduijn M, et al. Performance of the Cockcroft-Gault, MDRD, and new CKD-EPI formulas in relation to GFR, age, and body size. Clin J Soc Nephrol. 2010;5:1003–9. CrossRef Michels WM, Grootendorst DC, Verduijn M, et al. Performance of the Cockcroft-Gault, MDRD, and new CKD-EPI formulas in relation to GFR, age, and body size. Clin J Soc Nephrol. 2010;5:1003–9. CrossRef
13.
Zurück zum Zitat Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13. PubMedCentralPubMedCrossRef Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13. PubMedCentralPubMedCrossRef
14.
Zurück zum Zitat Seideman C, Park S, Best SL, et al. Self-retaining barbed suture for parenchymal repair during minimally invasive partial nephrectomy. J Endourol. 2011;25:1245–7. PubMedCrossRef Seideman C, Park S, Best SL, et al. Self-retaining barbed suture for parenchymal repair during minimally invasive partial nephrectomy. J Endourol. 2011;25:1245–7. PubMedCrossRef
15.
Zurück zum Zitat Olweny EO, Park SK, Seideman CA, et al. Self-retaining barbed suture for parenchymal repair during laparoscopic partial nephrectomy; initial clinical experience. BJU Int. 2012;109:906–9. PubMedCrossRef Olweny EO, Park SK, Seideman CA, et al. Self-retaining barbed suture for parenchymal repair during laparoscopic partial nephrectomy; initial clinical experience. BJU Int. 2012;109:906–9. PubMedCrossRef
16.
Zurück zum Zitat Porpiglia F, Volpe A, Billia M, et al. Laparoscopic versus open partial nephrectomy: analysis of the current literature. Eur Urol. 2008;53:732–42. PubMedCrossRef Porpiglia F, Volpe A, Billia M, et al. Laparoscopic versus open partial nephrectomy: analysis of the current literature. Eur Urol. 2008;53:732–42. PubMedCrossRef
17.
Zurück zum Zitat Margreiter M, Marberger M. Current status of open partial nephrectomy. Curr Opin Urol. 2010;20:361–4. PubMedCrossRef Margreiter M, Marberger M. Current status of open partial nephrectomy. Curr Opin Urol. 2010;20:361–4. PubMedCrossRef
18.
Zurück zum Zitat Zondervan PJ, Gozen AS, Opondo D, et al. Partial nephrectomy: is there an advantage of the self- retaining barbed suture in the perioperative period? A matched case-control comparison. World J Urol. 2012;30:659–64. PubMedCrossRef Zondervan PJ, Gozen AS, Opondo D, et al. Partial nephrectomy: is there an advantage of the self- retaining barbed suture in the perioperative period? A matched case-control comparison. World J Urol. 2012;30:659–64. PubMedCrossRef
Metadaten
Titel
Use of self-retaining barbed sutures decreases cold ischemia time in open nephron-sparing surgery
verfasst von
MD Ingrid Schauer
Oliver Theimer
MD Tobias Klatte
MD Matthias Waldert
MD Hans-Christoph Klingler
MD Markus Margreiter
Publikationsdatum
01.06.2014
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 11-12/2014
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-014-0529-1