Effective control of oozing from remnant tissue after partial nephrectomy, using fibrin tissue-adhesive collagen fleece

Author: Tsumura, Hiroaki

Source: Surgical Practice, Volume 7, Number 2, May 2003 , pp. 61-62(2)

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Abstract:

A 76-year-old man had complained of vomiting and diarrhea. A low echoic mass shown by abdominal ultrasonography with a clear margin in the right kidney was revealed. Digital subtraction angiography revealed a mass containing granular vascularity that was 18 mm in diameter and was protruding from the dorsal aspect of the kidney. He was diagnosed as having an encapsulated right renal cell carcinoma (T1N0M0, stage I). Partial nephrectomy was conducted as his renal function was poor. This was indicated by a preoperative creatinine clearance of 44.4 mL/min. After the resection of the tumour, the haemorrhage from the renal parenchyma did not stop by suturing. To control the oozing from the resection surface by electrical coagulation, liquid fibrin glue and powdered fibrin glue was used, however it was not successful. Thus, we decided to use fibrin tissue-adhesive collagen fleece (FTCF, TachoComb; Nycomed Pharma, Linz, Austria). The FTCF was placed on the resection surface and a pressure was applied to it for 5 min; oozing stopped completely. The use of FTCF contributed to the preservation renal function as there was no need to keep the seams as compared with suturing. The usefulness of FTCF in the partial nephrectomy is discussed in the present case report.

Keywords: fibrin tissue-adhesive collagen fleece; partial nephrectomy; TachoComb

Document Type: Research article

DOI: http://dx.doi.org/10.1046/j.1442-2034.2003.00169.x

Publication date: 2003-05-01