TriMatch comparison of the efficacy of FloSeal versus TachoSil versus no hemostatic agents for partial nephrectomy: Results from a large multicenter dataset
TriMatch comparison of the efficacy of FloSeal versus TachoSil versus no hemostatic agents for partial nephrectomy: Results from a large multicenter dataset
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DOI：
10.1111/iju.12603
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发表时间：
2015-01-01
影响因子：
2.6
通讯作者：
Serni, Sergio
中科院分区：
文献类型：
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作者：
Antonelli, Alessandro;Minervini, Andrea;Serni, Sergio
ObjectivesTo评估止血剂，TachoSil和FloSeal，在肾部分切除术期间使用一个大型的多中心dataset.MethodsData的1055例患者进行肾部分切除术2009年1月至2012年12月在19个意大利中心的观察性多中心研究（RECORD项目）内收集。根据中心和外科医生的偏好决定肾缝合术后是否使用止血剂以及所用止血剂的类型。采用TriMatch倾向评分分析，平衡三个研究组（无止血剂、TachoSil、FloSeal）的性别、年龄、手术适应症（择期/相对手术vs强制性手术）、临床分期（cT 1avscT 1b）、肿瘤外生性、方法（开放vs微创）、技术（标准肾部分切除vs简单剜出）、术前血红蛋白和肌酐。术前与术后第三天之间的血红蛋白和肌酐值的术后并发症和变化进行了compared.ResultsTriMatch分析使我们能够获得66个平衡良好的三胞胎。研究groups.ConclusionsThe目前的研究结果表明，在肾部分切除术中加入止血剂renorraphy没有提供更好的手术效果方面的差异。
ObjectivesTo evaluate the efficacy of hemostatic agents, TachoSil and FloSeal, during partial nephrectomy using a large multicenter dataset.MethodsData of 1055 patients who underwent partial nephrectomy between January 2009 and December 2012 in 19 Italian centers were collected within an observational multicentric study (RECORd Project). The decision whether or not to use hemostatic agents after renorrhaphy and the type of hemostatic agents applied was adopted according to the centers' and surgeons' preference. A TriMatch propensity score analysis was applied to balance three study groups (no hemostatic agents, TachoSil, FloSeal) for sex, age, surgical indication (elective/relative vs imperative), clinical stage (cT1avscT1b), tumor exophyticity, approach (open vs minimally invasive), technique (standard partial nephrectomy vs simple enucleation), preoperative hemoglobin and creatinine. Postoperative complications and variation of hemoglobin and creatinine values between preoperative versus third postoperative day were compared.ResultsTriMatch analysis allowed us to obtain 66 well-balanced triplets. No differences were found in terms of outcomes between the study groups.ConclusionsThe present findings suggest that adding hemostatic agents to renorraphy during partial nephrectomy does not provide better surgical outcomes.