The use of haemostatic agent: Impact on perioperative outcomes of partial nephrectomy [Impact de l'utilisation d'un agent hémostatique sur les complications périopératoires de la néphrectomie partielle]

摘要

Objective: To evaluate impact of the use of haemostatic agent in partial nephrectomy on perioperative outcomes. Material and methods: We reviewed the files of patients candidates for partial nephrectomy in our center between 2005 and 2010. The use of haemostatic agent and surgical procedure data were noted. Perioperative outcomes in haemostatic agent group were compared with perioperative outcomes in conventional surgical haemostasis group. Results: Among the 131 patients included, haemostatic agent was used in 91 cases (69.5%). There was no statistically difference between the two groups on age, sex, BMI, ASA score, tumor size and RENAL score. The use of haemostatic agent was more frequent for patients operated with laparoscopy (10.7%, P = 0.04). Concerning perioperative outcomes, there was no difference between the two groups on surgical complications, transfusions, conversion to radical nephrectomy and hospital stay. Median warm ischaemia time was comparable into the two groups. In multivariate analysis, haemorrhage, complications and transfusions were not predicted by the use of haemostatic agent. Conclusion: Use of haemostatic agent in partial nephrectomy had no benefice on perioperative outcomes in our series. Rapport between utility and cost for these agents must be discussed in partial nephrectomy.