止血凝膠在無腎造瘻管經皮腎造廔取石術的使用:台灣一家區域醫院之臨床經驗
藍祺昀、劉胤廷、鄒凱亦、胡書維、高偉棠、江怡德、吳佳璋、陳冠州
行政院衛生福利部雙和醫院 泌尿科
Use of hemostatic matrix in tubeless percutaneous nephrolithotomy: a single center experience from Taiwan
Chi-Yun Lan, Yin-Ting Liu, Kai-Yi Tzou, Su-Wei Hu, Chia-Chang Wu, Kuan-Chou Chen
Department of Urology, Taipei Medical University-Shuang Ho Hospital, Taipei, Taiwan
Abstract
Background
The tubeless PCNL offers several advantages over traditional PCNL, including reduction in hospital stay, decrease in analgesia requirements, and an earlier recovery to normal activities However, studies of performing tubeless PCNL with hemostatic matrix are limited. Our objective was to evaluate the efficacy and safety of tubeless PCNL with hemostatic matrix (Flosaeal hemostatic matrix )
Method
This is a retrospective review of PCNL database at our hospital between June 2014 and Dec 2015. During this period, total of 130 PCNLs were performed, including 38 with tubeless method which using the hemostatic matrix (Floseal, Baxter Medical, Fremont, California) at the conclusion of PCNL procedure. The standard PCNL group and Tubeless PCNL group were compared in aspect of demographic characteristics, perioperative data, and complication rate.
Result
In all, 71 man and 59 women with a mean age of 56 years were included in the analysis of 130 cases. Perioperative variable, including operative time, change in serum hemoglobin level, and peri-operative complication rate were all not significant in two groups. But transfusion rate, postoperative pain as measured on highest VAS score, analgesic dose during hospital stay, and hospital stay were lower in tubeless PCNL group.
Conclusion
Tubeless PCNL with hemostatic matrix is comparable with conventional PCNL, as regard to operation time, change in hemoglobin and creatinine, and perioperative complication. We found this approach was associated with less pain, less narcotic agent use and shorter hospital stay.