Polyethylene glycol-coated collagen patch (hemopatch(R)) in open partial nephrectomy

Purpose To describe the results of a polyethylene glycol-coated collagen patch, Hemopatch(R) on blood loss, surgical time and renal function in partial nephrectomy (PN) for renal cell carcinoma (RCC). Methods Out of a single surgeon cohort of n = 565 patients undergoing conventional open PN (CPN) between 01/2015 and 12/2017 at the University of Munich a consecutive subgroup (n = 42) was operated on using a polyethylene glycol-coated collagen-based sealant Hemopatch(R) (Baxter International Inc., Deerfield, IL, USA) (HPN). Results Median age was 65.2 years (range 12.7-95.2) with median follow-up of 9.43 months (0.03-49.15). Baseline renal function (CKD-EPI) was 78.56 ml/min/1.73 m(2) (range 20.38-143.09) with a non-significant decline to 74.78 ml/min/1.73 m(2) (range 3.75-167.74) at follow-up. In CPN 46% had low complexity, 33% moderate complexity and 20% high complexity lesions with 33% low, 40% moderate and 27% high complexity masses in HPN. Median tumor size was 4.3 cm (range 1-38 cm) in CPN with 4.8 cm (range 3.8-18.3 cm) with HPN, p = 0.293. Median blood loss and duration of surgery was significantly lower in the HPN group vs. CPN (146 ml +/- 195 vs. 114 ml +/- 159 ml; p = 0.021; 43 min +/- 27 for HPN vs. 53 min +/- 49; p = 0.035) with no difference in clamping time (12.6 min +/- 8.6 for HPN vs. 12.0 min +/- 9.5; p = 0.701). Conclusions Hemopatch(R) supported renoraphy shows promising results compared to standard renoraphy in PN. No side effects were seen. Further studies should evaluate the prevention of arterio-venous or urinary fistulas. In complex partial nephrectomies Hemopatch(R) supported renoraphy should be considered.

Automated summary

The use of Hemopatch(R) in partial nephrectomy resulted in lower blood loss and shorter surgery time compared to conventional methods, with minimal impact on renal function. Complexity of the procedure may influence the choice of surgical approach, and Hemopatch(R) could be beneficial for complex surgeries.