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Published on: March 27, 2018
Partial nephrectomy using porcine small intestinal submucosa
Thomas J Schnoeller1, Robert de Petriconi, Robert Hefty
1Department of Urology, Ulm University Medical Center, Prittwitzstrasse 43, D-89075 Ulm, Germany.
World Journal of Surgical Oncology
|October 14, 2011
Summary
Porcine small intestinal submucosa (SIS) effectively reduces urinary leakage and bleeding after nephron-sparing surgery for renal cell carcinoma (RCC). This biomaterial simplifies closure of renal defects, improving patient outcomes in complex cases.
Area of Science:
- Urology
- Surgical Innovation
- Biomaterials Science
Background:
- Nephron-sparing surgery is standard for localized renal cell carcinoma (RCC).
- Complications like urinary leakage and bleeding can occur, especially with large or central tumors.
- This study evaluates porcine small intestinal submucosa (SIS) for managing renal defects post-nephron-sparing surgery.
Purpose of the Study:
- To prospectively assess the efficacy and safety of using porcine small intestinal submucosa (SIS) as a closure material.
- To evaluate SIS's ability to prevent common complications following partial nephrectomy.
- To determine the utility of SIS in complex partial nephrectomy cases.
Main Methods:
- Prospective evaluation of 129 partial nephrectomies in 123 patients between August 2003 and February 2011.
- Application of porcine small intestinal submucosa (Surgisis®) to secure and compress the renal defect after tumor resection.
- Analysis of complication rates, including urinary fistula and postoperative hemorrhage.
Main Results:
- The median tumor size was 3.7 cm.
- Urinary fistula occurred in 3.1% of patients, and 1.6% required transfusions for hemorrhage.
- These complication rates were observed across procedures with varying ischemia times (cold, warm, or none).
Conclusions:
- Porcine small intestinal submucosa (SIS) is an effective and easy-to-use biomaterial for preventing postoperative bleeding and urinary fistula.
- SIS is particularly beneficial in nephron-sparing surgery cases with significant renal defects.
- The use of SIS can enhance patient outcomes by minimizing complications in partial nephrectomy.
