Pilot study comparing the two hemostatic agents in patients undergoing partial nephrectomy.

Area of Science:

• Urology
• Surgical Oncology
• Nephrology

Background:

• Nephron-sparing surgery (NSS) is a standard treatment for low-stage renal tumors, offering improved patient outcomes.
• Intra-operative hemorrhage is a risk during NSS, necessitating the use of hemostatic agents on the kidney's cut surface.
• This study compares the efficacy and safety of two commercially available hemostatic agents: Floseal® and Arista®.

Purpose of the Study:

• To compare the post-operative oncologic and non-oncologic outcomes of NSS using Floseal® versus Arista®.
• To evaluate the hemostatic efficacy and complication rates associated with each agent.
• To determine if either agent offers an advantage in managing renal hemorrhage during NSS.

Main Methods:

• Retrospective review of medical records for 23 patients who underwent open NSS.
• Application of either Floseal® (n=11) or Arista® (n=12) to the renal cut surface during surgery.
• Statistical comparison (Chi-square and T-student tests) of outcomes between the two hemostatic agent groups.

Main Results:

• The median renal mass size was 4.3 cm, with final pathology showing predominantly renal cell carcinoma.
• No significant differences were observed in mean intra-operative blood loss (227 mL vs. 250 mL) or hospital stay (4.4 days vs. 4.5 days) between Floseal® and Arista® groups.
• Intra-operative and post-operative complication rates were similar, and no tumor recurrences were noted at a mean follow-up of 18 months.

Conclusions:

• Both Floseal® and Arista® are effective hemostatic agents for use during NSS when combined with meticulous surgical technique.
• Neither agent was associated with a higher rate of intra-operative or post-operative hemorrhage.
• Either hemostatic agent can be successfully employed in NSS procedures for renal tumors.