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Comparison of the efficacy and histopathological effects of three hemostatic agents in a partial nephrectomy rat model

  • Urology - Original Paper
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Abstract

Purpose

The major complications of partial nephrectomy are bleeding and urine leakage. While various hemostatic agents are used to control bleeding, the histopathological characteristics of these hemostatic agents have not been investigated adequately. We aimed to investigate and compare the histopathological and hemostatic effects of local hemostatic agents in a partial nephrectomy rat model.

Methods

Thirty-two rats were divided into four equal groups, and partial nephrectomy was done to all rats. Conventional suture repair, Glubran2®, FloSeal®, and Celox™ were applied to every single group. The period of warm ischemia and hemostasis during surgical process was timed. Rats were killed later 3 weeks, and their partial nephrectomy applied kidneys were evaluated histopathologically.

Results

The fastest hemostasis was provided with Glubran2® (32.87 s). FloSeal® was the second (40.85 s), and Celox™ was the third (55.75 s). Glomerular necrosis and calcification were seen more in the suture group than other groups (p < 0.001). Fibrosis was found significantly less in Celox™ group. Fibroblast activation was found significantly less comparing to other groups (p < 0.01). The erythrocyte aggregation was significantly greater in the Glubran2® and FloSeal® groups than suture group (p < 0.01 and p < 0.001).

Conclusion

The negative effects of hemostatic agents to the renal histopathology were less than conventional suture repair. Celox™ was the best biocompatible agent. In comparison with three agents, it was observed that Glubran2® provided hemostasis faster than other agents.

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Abbreviations

HT:

Hemostasis time

PN:

Partial nephrectomy

WIT:

Warm ischemia time

References

  1. Ploussard G, Haddad R, Loutochin O et al (2015) A combination of hemostatic agents may safely replace deep medullary suture during laparoscopic partial nephrectomy in a pig model. J Urol 193:318–324

    Article  PubMed  CAS  Google Scholar 

  2. Breda A, Stepanian SV, Lam JS et al (2007) Use of haemostatic agents and glues during laparoscopic partial nephrectomy: a multi-institutional survey from the United States and Europe of 1347 cases. Eur Urol 52:798–803

    Article  PubMed  Google Scholar 

  3. Bergel S (1909) ‘The effect of the fibrin’ in German. Dtsch Med Wochenschr 35:663–665

    Article  CAS  Google Scholar 

  4. Radosevich M, Goubran H, Burnouf T (1997) Fibrin sealant: scientific rationale, production methods, properties and current clinical use. Vox Sang 72:133–143

    Article  PubMed  CAS  Google Scholar 

  5. Donaldson A, Jackman S (2002) Hand assisted laparoscopic (HAL) heminephrectomy in pigs utilizing AFAB. J Endourol 16:A20

    Google Scholar 

  6. Ramakumar S, Roberts W, Fugita O, Colegrove P, Nicol TM, Jarrett TW et al (2002) Local hemostasis during laparoscopic partial nephrectomy using biodegradable hydrogels: initial porcine experience. J Endourol 16:489–494

    Article  PubMed  Google Scholar 

  7. Ogan K, Jacomides L, Saboorian H, Koeneman K, Li Y, Napper C, Hoopman J et al (2003) Sutureless laparoscopic heminephrectomy using laser tissue soldering in the porcine model. J Endourol 17:295–300

    Article  PubMed  Google Scholar 

  8. Kakaei F, Seyyed Sadeghi MS, Sanei B et al (2013) A randomized clinical trial comparing the effect of different haemostatic agents for haemostasis of the liver after hepatic resection. HPG Surg 2013:587608

    Google Scholar 

  9. Echave M, Oyagüez I, Casado MA (2014) Use of Floseal®, a human gelatine-thrombin matrix sealant, in surgery: a systematic review. BMC Surg 14:111

    Article  PubMed  PubMed Central  Google Scholar 

  10. Zhang YJ, Gao B, Liu XW (2015) Topical and effective hemostatic medicines in the battlefield. Int J Clin Exp Med 8(1):10

    PubMed  PubMed Central  Google Scholar 

  11. Bermudez H, Guillonneau B, Gupta R, AdornoRosa J et al (2003) Initial experience in laparoscopic partial nephrectomy for renal tumor with clamping of renal vessels. J Endourol 17:373–378

    Article  PubMed  Google Scholar 

  12. Tekin Mİ, Peşkircioğlu L, Boyvat F et al (2000) Practical approach to terminate urinary extravasation: percutaneous fistüla tract embolization with n butyl cyanoacrylate in a case with partial nephrectomy. Tech Urol 7:67–69

    Google Scholar 

  13. Kim SH, Moon MW, Lee HJ et al (2003) Renal cyst ablation with n-butyl cyanoacrylate and ionized oil symptomatic patients with autosomal dominant polycystic kidney disease: preliminary report. Radiology 226:573–576

    Article  PubMed  Google Scholar 

  14. Grummet JP, Costello AJ, Swanson LC et al (2001) Vesicourethral anastomosis with 2-octyl cyanoacrylate adhesive in an in vivo canine model. Urology 60:935–938

    Article  Google Scholar 

  15. Reiter A (1987) Induction of sarcomas by the tissue-binding substance histoacryl-blau in therat. Z Exp Chir Transpl Kunstliche Organe 20:55–60

    CAS  Google Scholar 

  16. Pusateri AE, Holcomb JB, Bijan S, Kheirabadi BS, Alam HB, Wade CE, Ryan KL (2006) Making sense of the preclinical literature on advanced hemostatic products. J Trauma 60:674–682

    Article  PubMed  Google Scholar 

  17. Wedmore I, McManus JG, Pusateri AE, Holcomb JB (2006) A special report on the chitosan-based hemostatic dressing: experience in current combat operations. J Trauma 60:655–658

    Article  PubMed  Google Scholar 

  18. Favuzza J, Hechtman HB (2004) Hemostasis in the absence of clotting factors. J Trauma 57:S42–S44

    Article  PubMed  CAS  Google Scholar 

  19. Serizawa T, Yamaguchi M, Akashi M (2002) Alternating bioactivity of polymeric layer-by-layer assemblies: anticoagulation vs procoagulation of human blood. Biomacromolecules 3:724–731

    Article  PubMed  CAS  Google Scholar 

  20. Bak JB, Singh A, Shekarriz B (2004) Use of gelatin matrix thrombin tissue sealant as an effective hemostatic agent during laparoscopic partial nephrectomy. J Urol 171:780–782

    Article  PubMed  Google Scholar 

  21. Bagcioglu M, Huri E, Dadali M, Astarci HM, Sargon MF, Eroglu M (2014) Comparison of herbal-based and synthetic hemostatic agents for efficacy on a rat partial nephrectomy model. Saudi Med J 35:33–38

    PubMed  Google Scholar 

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Financial disclosure

The authors declared that this study did not receive any financial support.

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Authors and Affiliations

  1. Department of Urology, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey

    Mehmet Ozgur Yucel, Haci Polat, Can Benlioglu, Ali Cift & Alper Gok

  2. Department of Urology, Faculty of Medicine, Kafkas University, Kars, Turkey

    Murat Bagcioglu

  3. Department of Urology, Ankara Training and Research Hospital, Ankara, Turkey

    Tolga Karakan

  4. Department of Pathology, Ankara Training and Research Hospital, Ankara, Turkey

    Hesna Muzeyyen Astarci

  5. Ankara Training and Research Hospital, Ankara, Turkey

    Turgay Akgul

  6. Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey

    Cankon Germiyanoglu

Authors
  1. Mehmet Ozgur Yucel
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  2. Haci Polat
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  3. Murat Bagcioglu
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  4. Tolga Karakan
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  5. Can Benlioglu
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  6. Ali Cift
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  7. Alper Gok
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  8. Hesna Muzeyyen Astarci
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  9. Turgay Akgul
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  10. Cankon Germiyanoglu
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Corresponding author

Correspondence to Murat Bagcioglu.

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No conflict of interest was declared by the authors.

Ethics committee approval

All applicable international, national, and/or institutional guidelines for the care and use of animals were followed. The study was approved by the ethics committee of Ankara Education and Research Hospital.

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Yucel, M.O., Polat, H., Bagcioglu, M. et al. Comparison of the efficacy and histopathological effects of three hemostatic agents in a partial nephrectomy rat model. Int Urol Nephrol 48, 65–71 (2016). https://doi.org/10.1007/s11255-015-1129-3

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  • DOI: https://doi.org/10.1007/s11255-015-1129-3

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