The efficacy of the TachoSil binding suturing technique in laparoscopic partial nephrectomy to prevent the development of pseudoaneurysm

Keisuke Shigeta, Kazuhiro Matsumoto, Takayuki Abe, Akari Komatsuda, Toshikazu Takeda, Ryuichi Mizuno, Eiji Kikuchi, Hiroshi Asanuma, Yuki Arita, Hirotaka Akita, Masahiro Jinzaki, Akira Miyajima, Mototsugu Oya

Research output: Contribution to journalArticle

Abstract

Objective: Our specific aim was to introduce the TachoSil binding suturing technique for renal cell carcinoma (RCC) patients when closing the parenchymal defect after tumor excision during laparoscopic partial nephrectomy (LPN), which is a novel technique for reducing the risk of developing subsequent pseudoaneurysm (PA). Methods: We identified 113 pT1aN0M0 RCC patients who underwent LPN at our institution. Eighty-one (72%) patients underwent the suturing procedure without binding TachoSil, whereas 32 (28%) patients underwent renorraphy with the renal defect closed together with TachoSil. The vascular complications were evaluated by computed tomography or magnetic resonance imaging with enhanced contrast material at the first visit after LPN. We conducted Fischer's exact test to determine risk factors for transcatheter arterial embolization (TAE). Results: The median age was 55 (36–86) years old and the median follow-up time was 65 (12–147) months. In the overall population, there were 11 (11%) patients who underwent TAE because they developed PA. All 11 patients exhibited the imaging findings of PA, and were all from the conventional suturing group. In contrast, no patients for whom the TachoSil binding method was used had any significant findings on imaging (14% vs. 0%). Based on the analysis to determine risk factors for TAE due to PA development, the TachoSil binding suturing technique was one of the significant indicators for reducing the risk of developing PA. Conclusions: Our study demonstrated that the TachoSil binding suturing technique might reduce the development of PA after LPN. Prospective randomized study and comparison to the standard 2 or 3–layer renorrhaphy is needed to prove its actual value.

Original languageEnglish
JournalAsian Journal of Surgery
DOIs
Publication statusAccepted/In press - 2019 Jan 1

Fingerprint

False Aneurysm
Nephrectomy
Renal Cell Carcinoma
TachoSil
Contrast Media
Blood Vessels
Tomography
Magnetic Resonance Imaging
Prospective Studies
Kidney
Population
Neoplasms

Keywords

  • Laparoscopic partial nephrectomy
  • Pseudoaneurysm
  • TachoSil
  • Transcatheter arterial embolization

ASJC Scopus subject areas

  • Surgery

Cite this

@article{55e631689de140e1bf4aaa666582e71a,
title = "The efficacy of the TachoSil binding suturing technique in laparoscopic partial nephrectomy to prevent the development of pseudoaneurysm",
abstract = "Objective: Our specific aim was to introduce the TachoSil binding suturing technique for renal cell carcinoma (RCC) patients when closing the parenchymal defect after tumor excision during laparoscopic partial nephrectomy (LPN), which is a novel technique for reducing the risk of developing subsequent pseudoaneurysm (PA). Methods: We identified 113 pT1aN0M0 RCC patients who underwent LPN at our institution. Eighty-one (72{\%}) patients underwent the suturing procedure without binding TachoSil, whereas 32 (28{\%}) patients underwent renorraphy with the renal defect closed together with TachoSil. The vascular complications were evaluated by computed tomography or magnetic resonance imaging with enhanced contrast material at the first visit after LPN. We conducted Fischer's exact test to determine risk factors for transcatheter arterial embolization (TAE). Results: The median age was 55 (36–86) years old and the median follow-up time was 65 (12–147) months. In the overall population, there were 11 (11{\%}) patients who underwent TAE because they developed PA. All 11 patients exhibited the imaging findings of PA, and were all from the conventional suturing group. In contrast, no patients for whom the TachoSil binding method was used had any significant findings on imaging (14{\%} vs. 0{\%}). Based on the analysis to determine risk factors for TAE due to PA development, the TachoSil binding suturing technique was one of the significant indicators for reducing the risk of developing PA. Conclusions: Our study demonstrated that the TachoSil binding suturing technique might reduce the development of PA after LPN. Prospective randomized study and comparison to the standard 2 or 3–layer renorrhaphy is needed to prove its actual value.",
keywords = "Laparoscopic partial nephrectomy, Pseudoaneurysm, TachoSil, Transcatheter arterial embolization",
author = "Keisuke Shigeta and Kazuhiro Matsumoto and Takayuki Abe and Akari Komatsuda and Toshikazu Takeda and Ryuichi Mizuno and Eiji Kikuchi and Hiroshi Asanuma and Yuki Arita and Hirotaka Akita and Masahiro Jinzaki and Akira Miyajima and Mototsugu Oya",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.asjsur.2019.09.002",
language = "English",
journal = "Asian Journal of Surgery",
issn = "1015-9584",
publisher = "Elsevier Taiwan LLC",

}

TY - JOUR

T1 - The efficacy of the TachoSil binding suturing technique in laparoscopic partial nephrectomy to prevent the development of pseudoaneurysm

AU - Shigeta, Keisuke

AU - Matsumoto, Kazuhiro

AU - Abe, Takayuki

AU - Komatsuda, Akari

AU - Takeda, Toshikazu

AU - Mizuno, Ryuichi

AU - Kikuchi, Eiji

AU - Asanuma, Hiroshi

AU - Arita, Yuki

AU - Akita, Hirotaka

AU - Jinzaki, Masahiro

AU - Miyajima, Akira

AU - Oya, Mototsugu

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objective: Our specific aim was to introduce the TachoSil binding suturing technique for renal cell carcinoma (RCC) patients when closing the parenchymal defect after tumor excision during laparoscopic partial nephrectomy (LPN), which is a novel technique for reducing the risk of developing subsequent pseudoaneurysm (PA). Methods: We identified 113 pT1aN0M0 RCC patients who underwent LPN at our institution. Eighty-one (72%) patients underwent the suturing procedure without binding TachoSil, whereas 32 (28%) patients underwent renorraphy with the renal defect closed together with TachoSil. The vascular complications were evaluated by computed tomography or magnetic resonance imaging with enhanced contrast material at the first visit after LPN. We conducted Fischer's exact test to determine risk factors for transcatheter arterial embolization (TAE). Results: The median age was 55 (36–86) years old and the median follow-up time was 65 (12–147) months. In the overall population, there were 11 (11%) patients who underwent TAE because they developed PA. All 11 patients exhibited the imaging findings of PA, and were all from the conventional suturing group. In contrast, no patients for whom the TachoSil binding method was used had any significant findings on imaging (14% vs. 0%). Based on the analysis to determine risk factors for TAE due to PA development, the TachoSil binding suturing technique was one of the significant indicators for reducing the risk of developing PA. Conclusions: Our study demonstrated that the TachoSil binding suturing technique might reduce the development of PA after LPN. Prospective randomized study and comparison to the standard 2 or 3–layer renorrhaphy is needed to prove its actual value.

AB - Objective: Our specific aim was to introduce the TachoSil binding suturing technique for renal cell carcinoma (RCC) patients when closing the parenchymal defect after tumor excision during laparoscopic partial nephrectomy (LPN), which is a novel technique for reducing the risk of developing subsequent pseudoaneurysm (PA). Methods: We identified 113 pT1aN0M0 RCC patients who underwent LPN at our institution. Eighty-one (72%) patients underwent the suturing procedure without binding TachoSil, whereas 32 (28%) patients underwent renorraphy with the renal defect closed together with TachoSil. The vascular complications were evaluated by computed tomography or magnetic resonance imaging with enhanced contrast material at the first visit after LPN. We conducted Fischer's exact test to determine risk factors for transcatheter arterial embolization (TAE). Results: The median age was 55 (36–86) years old and the median follow-up time was 65 (12–147) months. In the overall population, there were 11 (11%) patients who underwent TAE because they developed PA. All 11 patients exhibited the imaging findings of PA, and were all from the conventional suturing group. In contrast, no patients for whom the TachoSil binding method was used had any significant findings on imaging (14% vs. 0%). Based on the analysis to determine risk factors for TAE due to PA development, the TachoSil binding suturing technique was one of the significant indicators for reducing the risk of developing PA. Conclusions: Our study demonstrated that the TachoSil binding suturing technique might reduce the development of PA after LPN. Prospective randomized study and comparison to the standard 2 or 3–layer renorrhaphy is needed to prove its actual value.

KW - Laparoscopic partial nephrectomy

KW - Pseudoaneurysm

KW - TachoSil

KW - Transcatheter arterial embolization

UR - http://www.scopus.com/inward/record.url?scp=85073986463&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85073986463&partnerID=8YFLogxK

U2 - 10.1016/j.asjsur.2019.09.002

DO - 10.1016/j.asjsur.2019.09.002

M3 - Article

AN - SCOPUS:85073986463

JO - Asian Journal of Surgery

JF - Asian Journal of Surgery

SN - 1015-9584

ER -