Use of fibrin glue in percutaneous nephrolithotomy

Mikhail, Albert A.; Kaptein, John S.; Bellman, Gary C.

doi:10.1016/s0090-4295(03)00112-2

Cited by 80 publications

(34 citation statements)

References 14 publications

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“…Milkahi and his colleagues introduced instillation of a hemostatic agent Tiseel into the nephrostomy tract for the first time. 18 However, they were unable to determine if injection of that agent diminished postoperative bleeding or urinary extravasation following tubeless PCNL. Choi et al instilled gel matrix thrombin (Floseal) in the tract whenever persistent bleeding was observed after omitting the nephrostomy catheter.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative Patient Selection for Tubeless Percutaneous Nephrolithotomy

Lee

Kim

et al. 2014

International Surgery

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This study was conducted to report our experience of intraoperative patient selection for tubeless percutaneous nephrolithotomy (PCNL) based on a tentative decision-making algorithm. Thirty-four consecutive patients who were scheduled to undergo tubeless PCNL were included and medical records were obtained from a prospectively maintained database for these patients. After completion of PCNL, the nephrostomy site was observed with a safety guidewire in place. If there was no significant bleeding through the tract, tubeless PCNL was performed, and in cases with significant bleeding or other complications, nephrostomy catheter insertion was performed as usual. In 29 cases (85.3%), tubeless PCNL was performed according to our decision-making protocol. Mean stone size was 7.33 6 9.35 cm 2 . Mean hospital stay was 2.61 6 1.01 days. The difference between preoperative and postoperative hemoglobin was 0.68 6 1.22 g/dL (p . 0.05). Visual analog pain scale scores immediately post-operation, on postoperative day one and on the day of discharge were 4.62 6 1.80, 3.25 6 1.68 (postoperative day one vs. operative day; p ¼ 0.001), and 1.87 6 0.83 (the day of discharge vs. operative day; p ¼ 0.001), respectively. The success rate with insignificant remnant stones was 85.2% and complete stone-free rate was 76.5%. In conclusion, tubeless PCNL was performed successfully with low complication rate and reduced pain score through our decision-making algorithm.

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Section: Discussionmentioning

confidence: 99%

Intraoperative Patient Selection for Tubeless Percutaneous Nephrolithotomy

Lee

Kim

et al. 2014

International Surgery

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“…Mikhail et al . [ 13 ] fi rst reported on the use of fi brin glue sealants in 20 patients undergoing PCNL and concluded that the use of the glue was safe and was associated with decreased hospital stay. Similar to the present fi ndings, no statistical or clinical difference was found in postoperative haematocrit when compared with tubeless cases without the use of fi brin glue.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous stone surgery using a tubeless technique with fibrin sealant: report of our first 107 cases

et al. 2012

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Study Type – Therapy (case series)Level of Evidence 4What's known on the subject? and What does the study add?Small case series support the safety and efficacy of tubeless PCNL with fibrin sealant. However, there is a paucity of data from larger case series supporting this approach.To our knowledge, this is among the largest tubeless PCNL series. We found the use of fibrin sealant for tubeless PCNL was associated with excellent stone‐free rates (approaching 90%), short hospitalisation, and low complication rates. Tubeless PCNL with nephrostomy tract fibrin sealant appears to be viable option for appropriately select patients.OBJECTIVE To report on our first 107 cases of tubeless percutaneous nephrolithotomy (PCNL) using fibrin sealant as a haemostatic agent within the access tract. PCNL is the preferred treatment for patients with large renal stones, and the tubeless technique with the use of fibrin sealant has recently gained popularity. PATIENTS AND METHODS We performed a retrospective review of single‐access, PCNL cases performed without a nephrostomy tube from January 2002 to July 2008. Nephrostomy tracts were sealed at the conclusion of each procedure with fibrin‐containing haemostatic agents. We evaluated demographic variables, tracked complications, and compared pre‐ and postoperative haemoglobin, haematocrit and creatinine levels. On postoperative day 1 computed tomography was used to determine stone‐free rates. Student's t‐test calculations were used to determine statistical significance at P≤ 0.05. RESULTS In all, 59 men and 48 women with a mean age of 43 years were included in the analysis of 107 cases. The mean stone size was 2.9 cm2 and the average hospital stay was 1.07 days. Pre‐ and postoperative changes in serum haemoglobin and serum creatinine were not statistically different. Postoperative haematocrit declined by a mean of 4.5% (P≤ 0.05), but no patients required a transfusion. Stone‐free rates were 72% overall, and 90% when excluding patients with residual fragments of <4 mm. Complications included seven asymptomatic subcapsular haematomas, one pseudoaneurysm requiring selective embolization, one urine leak, and five return visits to the emergency room for pain. CONCLUSIONS The use of fibrin sealant in this large tubeless PCNL series was associated with favourable stone‐free rates, short hospital stays, and low complication rates with no significant bleeding. Tubeless PCNL with nephrostomy tract fibrin sealant appears to be a viable option for appropriately selected patients, but future randomised trials are warranted.

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“…Such limitations must be raised for the operators and their operations. To limit the risks of urinary leakage and bleeding, sealant hemostatic materials such as fibrin glue and gelatin matrix have been shown to efficiently and safely control the bleeding [19,20]. Hoznek et al [21] proposed kidney closure with resorcinol glue after nephrotomy.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Ipsilateral Renal Ureteral Calculi by Combining Retroperitoneal Laparoscopic Surgery with Tubeless Mini-Percutaneous Nephrolithotomy

Sun¹,

Peng

2012

Urol Int

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Objectives: To report and discuss the role of the treatment of ipsilateral renal and upper middle ureteral stones in patients by combing retroperitoneal laparoscopic surgery with tubeless mini-percutaneous nephrolithotomy. Patients and Methods: Eleven patients associated with ipsilateral renal and upper middle ureteral stones underwent combing retroperitoneal laparoscopic surgery with tubeless mini-percutaneous nephrolithotomy after failure of shockwave or ureteroscopy lithotripsy. Their data were analyzed retrospectively including stone burden, perioperative complications and outcomes. Results: All the patients underwent retroperitoneal laparoscopic ureterolithotomy and tubeless mini-percutaneous nephrolithotomy successfully. Surgical time ranged from 80 to 160 min with a mean of 118 min. The mean hospital stay was 4 days (3-7 days). The mean length of retroperitoneal urinary drainage was 3 days (2-6 days). There were minor complications in 3 (27.2%) patients. The stone-free rate was 82% (9 patients). Two patients had a residual calyceal fragment that was treated with shockwave lithotripsy. All of them were followed up for 3-24 months. Renal function was improved in different degree. Conclusion: In carefully selected patients, combining retroperitoneal laparoscopic surgery with tubeless mini-percutaneous nephrolithotomy can treat ipsilateral renal and upper middle ureteral calculi by a single procedure with advantages of high stone-free rate, safety, reliability, rapid recovery and less complications.

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Use of fibrin glue in percutaneous nephrolithotomy

Cited by 80 publications

References 14 publications

Intraoperative Patient Selection for Tubeless Percutaneous Nephrolithotomy

Intraoperative Patient Selection for Tubeless Percutaneous Nephrolithotomy

Percutaneous stone surgery using a tubeless technique with fibrin sealant: report of our first 107 cases

Treatment of Ipsilateral Renal Ureteral Calculi by Combining Retroperitoneal Laparoscopic Surgery with Tubeless Mini-Percutaneous Nephrolithotomy

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