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.
Zusammenfassung
Ziel
Das Ziel dieser Studie lag in der Untersuchung, ob die Verwendung selbsthaltenden Nahtmaterials im Vergleich zu konventionellem Nahtmaterial bei Nierenteilresektionen zur Verbesserung der Operationsergebnisse führt.
Methoden
Es wurde eine retrospektive Analyse von 50 konsekutiven Patienten durchgeführt, die sich wegen eines unizentrischen Nierentumors einer Nierenteilresektion unterzogen. Bei 15 Patienten wurde selbsthaltendes Nahtmaterial zur Parenchymrekonstruktion verwendet, bei 35 Patienten konventionelles Nahtmaterial. Mit dem Operationsresultat assoziierte Parameter wurden sowohl für die gesamte Patientenpopulation, als auch nach Unterteilung in Untergruppen anhand der PADUA-Klassifikation erhoben und ausgewertet.
Ergebnisse
Hinsichtlich der präoperativen Parameter gab es keinen Unterschied zwischen den beiden Gruppen. Der Mittelwert (± Standardabweichung) der Ischämiezeit zeigte einen signifikanten Unterschied zwischen der Gruppe, in der das selbsthaltende Nahtmaterial verwendet wurde (15,2 ± 6,9 min) und der konventionellen Gruppe (25,7 ± 11,8 min). Es gab keinen statistisch signifikanten Unterschied hinsichtlich der postoperativen Hämoglobinwerte, dem Abfall des Hämoglobins in Prozent oder der Nierenfunktion zwischen den Gruppen. Die Subgruppenanalyse zeigte einen signifikanten Unterschied hinsichtlich der Ischämiezeit nur in der Untergruppe 1 (PADUA 6 und 7), ohne Auswirkungen auf die postoperativen Parameter.
Schlussfolgerung
Der Einsatz selbsthaltenden Nahtmaterials im Rahmen der Parenchymrekonstruktion bei offenen Nierenteilresektionen scheint eine sichere Option darzustellen und führte zu einer signifikanten Verkürzung der Ischämiezeit. In der PADUA-Subgruppenanalyse konnte dieser Unterschied nur in der Untergruppe 1 festgestellt werden.
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Conflict of interest
The authors Ingrid Schauer, Oliver Theimer, Tobias Klatte, Matthias Waldert, Hans-Christoph Klingler, and Markus Margreiter declare that there is no conflict of interest in relation to this article.
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Schauer, I., Theimer, O., Klatte, T. et al. Use of self-retaining barbed sutures decreases cold ischemia time in open nephron-sparing surgery. Wien Klin Wochenschr 126, 329–334 (2014). https://doi.org/10.1007/s00508-014-0529-1
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DOI: https://doi.org/10.1007/s00508-014-0529-1
Keywords
- Open nephron-sparing surgery
- Partial nephrectomy
- Cold ischemia time
- Self-retaining barbed sutures
- Renal cell carcinoma