Faculty Collaboration Database

Novel modification of partial nephrectomy technique using porcine small intestine submucosa. Urology 2002 Nov;60(5):906-9

Date

11/14/2002

Pubmed ID

12429327

DOI

10.1016/s0090-4295(02)01965-9

Scopus ID

2-s2.0-0036844832 (requires institutional sign-in at Scopus site)   21 Citations

Abstract

INTRODUCTION: To describe a novel partial nephrectomy technique that uses small intestine submucosa (SIS) to ensure a watertight closure of the collecting system and minimize parenchymal bleeding. The indications for nephron-sparing surgery have increased in recent years. The most prevalent complications after partial nephrectomy include urinary leakage/fistula and parenchymal bleeding. Porcine SIS has been used in animal models to reconstruct portions of the urinary tract successfully.

TECHNICAL CONSIDERATIONS: Twenty-two consecutive patients underwent 24 partial nephrectomies that required entry into the collecting system for presumed renal cell carcinoma. After temporary occlusion of the renal vessels and renal hypothermia, the tumor and a margin of normal parenchyma were excised. The cut surface was cauterized with an argon beam coagulator, and visible vessels were suture ligated. The collecting system was reapproximated with interrupted, absorbable sutures. A multilayer piece of hydrated SIS was sutured in place over the exposed collecting system and parenchymal defect with several figure-of-eight chromic sutures. With a mean follow-up of 18.4 months, none of the 22 patients experienced postoperative urinary leaks/fistulas or postoperative hemorrhage requiring transfusion. The serum creatinine returned to within 0.2 mg/dL of baseline in all patients after surgery.

CONCLUSIONS: We describe a novel technique of partial nephrectomy using SIS, which, we believe, aids in closure of the collecting system and decreases parenchymal bleeding.

Author List

O'connor RC, Harding JN 3rd, Steinberg GD

Author

Robert Corey O'Connor MD Professor in the Urologic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Animals
Biological Dressings
Carcinoma, Renal Cell
Female
Humans
Intestinal Mucosa
Intestine, Small
Kidney Neoplasms
Male
Middle Aged
Nephrectomy
Swine