a prospective, randomized trial evaluating the safety and efficacy of fibrin sealant in tubeless percutaneous nephrolithotomy：一项前瞻性，随机试验的安全性和纤维蛋白封闭剂在内胎的经皮肾镜取石术疗效评价.pdfVIP

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2016-03-12 发布于广东
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a prospective, randomized trial evaluating the safety and efficacy of fibrin sealant in tubeless percutaneous nephrolithotomy：一项前瞻性，随机试验的安全性和纤维蛋白封闭剂在内胎的经皮肾镜取石术疗效评价.pdf

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a prospective, randomized trial evaluating the safety and efficacy of fibrin sealant in tubeless percutaneous nephrolithotomy：一项前瞻性，随机试验的安全性和纤维蛋白封闭剂在内胎的经皮肾镜取石术疗效评价

A Prospective, Randomized Trial Evaluating the Safety and Efﬁcacy of Fibrin Sealant in Tubeless Percutaneous Nephrolithotomy Hemendra N. Shah,* Sunil Hegde, Jignesh N. Shah, Pradnya D. Mohile, Thyavihally B. Yuvaraja and Manish B. Bansal From the R. G. Stone Urological Research Institute and Tata Memorial Hospital (TBY), Mumbai, India Purpose: We performed a prospective, randomized trial to assess the safety and efﬁcacy of ﬁbrin sealant in tubeless percutaneous nephrolithotomy. Materials and Methods: A total of 63 patients undergoing tubeless percutaneous nephrolithotomy were randomized to receive Tisseel® vapor heated sealant at the end of the procedure. Fibrin sealant was instilled under direct vision in the nephrostomy tract at the end of the procedure. Patients younger than 14 years and those undergoing staged percutaneous nephrolithotomy or bilateral simultaneous percutaneous nephrolithotomy were excluded from study. Patients needing greater than 2 percutaneous tracts, those with signiﬁcant bleeding or associated pyonephrosis and those with a residual stone burden were also excluded from study. The perioperative outcome in these patients (experimental group) was compared with the outcome in those undergoing tubeless percutaneous nephrolithotomy without ﬁbrin sealant (control group). Results: Fibrin sealant was instilled in 32 patients. There was no difference in the hematocrit decrease and blood transfusion requirement in the 2 groups. Patients in the experimental group experienced less postoperative pain and required less analgesia. They were discharged home 5 hours earlier than patients in the control group. However, this difference was not statistically signiﬁcant. Complete stone clearance was achieved in 87.5% of patients in the experimental group and in 90.32% of controls. Conclusions: The instillation of Tisseel® ﬁbrin glue is safe for tubeless