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A Modified Two-Layer Suture Technique for Transperitoneal Laparoscopic Partial Nephrectomy: Single-Center Clinical

Yang Jin¹, Hui Xiong², Qinghua Xia²

¹Medical Research Center, Hospital Affiliated to Binhai University, Qingdao, China.

Frontiers in Surgery

|February 18, 2022

Summary

A modified two-layer suture method for laparoscopic partial nephrectomy (LPN) is feasible and effective. This technique demonstrated a shorter clamping time and less reduction in glomerular filtration rate (GFR) compared to traditional methods.

Keywords:

blood urea nitrogen glomerular filtration rate laparoscopic partial nephrectomy suture warm ischemic time

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Area of Science:

Urology
Surgical Innovation
Nephrology

Background:

Laparoscopic partial nephrectomy (LPN) is a standard procedure for kidney tumor removal.
Optimizing surgical techniques in LPN is crucial for preserving renal function.
Traditional two-layer suture methods can impact operative time and renal outcomes.

Purpose of the Study:

To evaluate the feasibility and efficacy of a modified two-layer suture method in LPN.
To compare the outcomes of the modified suture technique against the traditional two-layer suture.
To assess the impact of suture methods on surgical characteristics and postoperative renal function.

Main Methods:

A comparative study involving 60 LPN patients, divided into modified (30) and traditional (30) suture groups.
Surgical metrics recorded included operative time, warm ischemic time (WIT), estimated blood loss (EBL), and glomerular filtration rate (GFR).
Univariable and multivariable linear regression analyses were employed to determine correlations.

Main Results:

No significant differences were observed in patient/tumor characteristics or postoperative creatinine/BUN levels between groups.
The modified suture group exhibited significantly shorter clamping times (15 vs. 23 min) and less GFR reduction (p < 0.05).
The modified two-layer suture was identified as an independent factor influencing clamping time and GFR reduction.

Conclusions:

The modified two-layer suture method is a feasible and effective technique for LPN.
This modified approach offers potential advantages in reducing warm ischemia time and preserving renal function.
Further research may validate these findings and promote wider adoption of the modified technique.