童綜合醫院 外科部 泌尿科
Our experience of tissue glue injection in tubeless percutaneous nephrolithotomy
I-Yen Lee, Chao-Yu Hsu, Min-Che Tung, Jue-Hawn Yin
, Hao-Ping Tai, Siu-San Tse, Hsiang-Lai Chen
Divisions of Urology, Department of Surgery, Tungs’ Taichung MetroHarbor Hospital, Taichung, Taiwan
Purpose: To share our experience with the use of Tissucol Duo or Floseal during tubeless percutaneous nephrolithotomy, we evaluated its clinical beneﬁt with respect to length of hospital stay, analgesic usage and hemoglobin level change.
Materials and Methods: We retrospectively reviewed of 500 patients who underwent percutaneous nephrolithotomy in our hospital. In 100 consecutive patients, percutaneous tracts were injected with 5 mL of Tissucol Duo Quick after removal of Ampulla sheath. We compared the days of hospitalization, age, stone burden, operation time, and complications between 100 patients who received tubeless percutaneous nephrolithotomy with fibrin glue use (experimental group) and 400 patients who received percutaneous nephrolithotomy without use of tissue glue (control group).
Results: The average days of hospital stay was 0.92 day (P=0.02) shorter in the experimental group than in the control group. Age distribution between two groups was not statistically different. The decreased level of Hematocrit was 20% lesser in the experimental than in the control groups. The total usage of analgesic agent was less in the experimental group, but the difference was not statistically signiﬁcant between two groups. No statistical difference was noted between the operative times, stone burden, and complication for both groups. Postoperative blood transfusion, fever and wound infection were found in 10 patients in the experimental group and 50 patients in the control group. Three patients expired due to hemorrhagic shock and sepsis.
Conclusions: The use of ﬁbrin glue is safe and clinical benefit in the length of hospitalization, hemoglobin level maintenance in percutaneous nephrolithotomy procedures. Additional prospective randomized studies are needed for more clinical beneﬁt evaluation.