Robotik parsiyel nefrektomide renorafi için geleneksel poliglaktin ile dikenli dikiş materyallerinin karşılaştırılması

Abstract

Amaç: Robotik parsiyel nefrektomi RPN esnasında renorafide geleneksel emilebilen dikiş materyalleri ile dikenli dikiş materyalleri kullanımının cerrahi sonuçlar üzerine etkisini değerlendirmek.Gereç ve Yöntemler: 2009 ve 2011 yılları arasında böbrekte kitle sebebiyle RPN yapılan 38 hasta çalışmaya dahil edildi. Bu 38 hastanın 16’sında renorafi poliglaktin Grup 1 ve 22’sinde ise dikenli poliglikonat dikiş materyali Grup 2 ile yapıldı. Gruplar arasında ortalama operasyon süresi, tahmini kan kaybı, sıcak iskemi süresi, hastanede kalış süresi, komplikasyonlar ve onkolojik sonuçlar prospektif olarak değerlendirildi. Bulgular: Gruplar arasında yaş, cinsiyet, komorbidite ve tümör karakteristikleri açısından istatistiksel olarak anlamlı farklılık izlenmedi. Ortalama operasyon süresi Grup 1’de 163±55 dakika iken Grup 2’de 137±18 dakika idi p=0,001 . Tahmini kan kaybı Grup 1’de 472±540 mil. iken Grup 2’de 185±110 mil. idi p=0,001 . Ortalama hematokrit düşüşü Grup 1’de %6,43±3,4 iken Grup 2’de %3,82±2,7 idi p=0,015 . Sıcak iskemi süresi Grup 1’de ortalama 28.7±9.3 dakika iken, Grup 2’de ortalama 20,9±6,9 dakika idi p=0,001 . Ortalama takip süresi gruplar arasında sırasıyla 24 ve 18 aydı. Takip süresince her iki grupta da tümör rekürrensine rastlanılmadı.Sonuç: Robotik parsiyel nefrektomide renorafi için dikenli sütür materyallerinin kullanımı böbrek parankim onarımının hızlı, güvenli ve kuvvetli yapılmasını kolaylaştırmaktadır. Böbrek parankim onarımının dikenli dikiş materyalleri ile yapılması sıcak iskemi süresini ve tahmini kan kaybını azaltmaktadır

Keywords

• Böbrek,kanser,robot,parsiyel nefrektomi

Comparison of barbed and conventional polyglactin sutures for renorraphy in robot assisted partial nephrectomy

Abstract

Objective: To evaluate the effect of the barbed and the conventional absorbable sutures for renorraphy on the outcomes of robot assisted partial nephrectomy RAPN .Material and Methods: Between 2009 and 2011, a total 38 patients with a renal mass who underwent RAPN were included in this study. Of 38, renorraphy was performed with a polyglactin suture in 16 patients Group 1 and, with a barbed polyglyconate suture in 22 patients Group 2 . The mean operative time, estimated blood loss EBL , warm ischemia time WIT , hospital stay, complications and oncologic outcomes were evaluated prospectively.Results: There was no statistical difference between groups in terms of age, gender, comorbidities and tumor characteristics. The mean operative time was 163± 55 min in Group 1 and 137 ± 18 min Group 2 p=0,001 . The mean EBL was 472 ± 540 ml in Group 1 and 185± 110 ml in Group 2 p=0,001 . The mean decline in hematocrit was %6.43 ± 3.4 in Group 1 and %3.82 ± 2.7 in Group 2 p=0.015 . The WIT was 28.7 ± 9.3 min and 20.9 ± 6.9 min p=0.005 in Group 1 and 2, respectively. The mean follow up was 24 and 18 months in Group 1 and 2, respectively. No tumor recurrence has occurred in both groups at the follow-up.Conclusions: Utilization of barbed sutures for renorraphy during RAPN facilitates rapid, safe and potent renal parenchymal repair. Renorraphy with barbed suture results in reduced warm ischemia time and blood loss

Keywords

• kidney,cancer,robot,partial nephrectomy

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