BACKGROUND: To compare perioperative and functional outcomes associated with renorrhaphy performed with two different types of clips (Absolok® vs. Hem-o-Lok®) in a contemporary series of patients who underwent partial nephrectomy. METHODS: Patients in whom Absolok® clips were used to perform haemostasis at the level of tumor bed or to block the running sutures during sliding-clip renorrhaphy (study group) were compared with a contemporary control group of patients in whom renorrhaphy was performed with Hem-o-Lok® clips. Both groups received the same surgical technique via an open or robot-assisted approach. Inner renorrhaphy was performed with one or more 3-0 (26 mm needle) monofilament running suture(s) preloaded with medium Absolok® clips in the study group, and with medium Hem-o-Lok® clips in the control group. Cortical renorrhaphy was performed using interrupted 2-0 (26 mm needle) polyfilament sutures placed at intervals of 1 cm using the sliding-clip technique with Absolok® clips in the study group and with Hem-o-Lok® clips in the control group. Intraoperative and postoperative outcomes were compared. RESULTS: Absolok® clips were used in 57 patients, while Hem-o-Lok® clips were used in 40 patients. The two groups were comparable for all preoperative patient and tumor characteristics. No differences were observed in terms of operating room time (P=0.29), off-clamp technique rate (P=0.96), warm ischemia time (P=0.19) and estimated blood loss (P=0.18). No difference in the rate of positive surgical margins was detected (P=0.21). Ninety-day complications were observed in 32 (33%) cases. No difference in overall and major postoperative complications were observed between the two groups (P=0.20). Abdominal CT scan performed after 3 months following surgery showed no Absolok® clips in all cases. CONCLUSIONS: Absolok® clips are a valid alternative to Hem-o-Lok® clips to secure blood vessels at the level of tumor bed and to perform a sliding-clip renorrhaphy in patients who underwent open or robot-assisted partial nephrectomy.

Rossanese M., Crestani A., Giannarini G., Calandriello M., Alario G., Simonato A., et al. (2020). Absolok® versus Hem-o-Lok® clips for renorrhaphy during partial nephrectomy for parenchymal renal tumors. MINERVA UROLOGICA E NEFROLOGICA, 72(1), 91-98 [10.23736/S0393-2249.19.03598-7].

Absolok® versus Hem-o-Lok® clips for renorrhaphy during partial nephrectomy for parenchymal renal tumors

Alario G.;Simonato A.
Membro del Collaboration Group
;
2020-01-01

Abstract

BACKGROUND: To compare perioperative and functional outcomes associated with renorrhaphy performed with two different types of clips (Absolok® vs. Hem-o-Lok®) in a contemporary series of patients who underwent partial nephrectomy. METHODS: Patients in whom Absolok® clips were used to perform haemostasis at the level of tumor bed or to block the running sutures during sliding-clip renorrhaphy (study group) were compared with a contemporary control group of patients in whom renorrhaphy was performed with Hem-o-Lok® clips. Both groups received the same surgical technique via an open or robot-assisted approach. Inner renorrhaphy was performed with one or more 3-0 (26 mm needle) monofilament running suture(s) preloaded with medium Absolok® clips in the study group, and with medium Hem-o-Lok® clips in the control group. Cortical renorrhaphy was performed using interrupted 2-0 (26 mm needle) polyfilament sutures placed at intervals of 1 cm using the sliding-clip technique with Absolok® clips in the study group and with Hem-o-Lok® clips in the control group. Intraoperative and postoperative outcomes were compared. RESULTS: Absolok® clips were used in 57 patients, while Hem-o-Lok® clips were used in 40 patients. The two groups were comparable for all preoperative patient and tumor characteristics. No differences were observed in terms of operating room time (P=0.29), off-clamp technique rate (P=0.96), warm ischemia time (P=0.19) and estimated blood loss (P=0.18). No difference in the rate of positive surgical margins was detected (P=0.21). Ninety-day complications were observed in 32 (33%) cases. No difference in overall and major postoperative complications were observed between the two groups (P=0.20). Abdominal CT scan performed after 3 months following surgery showed no Absolok® clips in all cases. CONCLUSIONS: Absolok® clips are a valid alternative to Hem-o-Lok® clips to secure blood vessels at the level of tumor bed and to perform a sliding-clip renorrhaphy in patients who underwent open or robot-assisted partial nephrectomy.
Rossanese M., Crestani A., Giannarini G., Calandriello M., Alario G., Simonato A., et al. (2020). Absolok® versus Hem-o-Lok® clips for renorrhaphy during partial nephrectomy for parenchymal renal tumors. MINERVA UROLOGICA E NEFROLOGICA, 72(1), 91-98 [10.23736/S0393-2249.19.03598-7].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10447/407244
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