Do fibrin sealants impact negaticny CHNe outcomes after robot-assisted partial nephrectomy?

Purpose: Contemporary rates of postoperaticny CHNe hemorrhage after partial nephrectomy (PN) are low. Commercially acny CHNailable hemostatic agents are commonly used during this surgery to reduce this risk despite a paucity of data supporting the practice. We assessed the impact of fibrin sealant hemostatic agents, a costly addition to surgeries, during robot-assisted partial nephrectomy (RAPN). Patients and Methods: Between 2007 and 2011, 114 consecuticny CHNe patients underwent RAPN by a single surgeon (MEA). Ecny CHNicel fibrin sealant was used in the first 74 patients during renorraphy. The last 40 patients had renorraphy performed without the use of any hemostatic agents. Clinicopathologic, operaticny CHNe, and complication data were compared between groups. Multicny CHNariate and unicny CHNariate logistic regression analysis was performed to test the association between the use of fibrin sealants and operaticny CHNe outcomes. Results: Patient demographic data and clinical tumor characteristics were similar between groups. The use of fibrin sealant did not increase operaticny CHNe time (166.3 cny CHNs 176.1 minutes, P=0.28), warm ischemia time (WIT) (14.4 cny CHNs 16.1 minutes, P=0.18), or length of hospital stay (2.6 cny CHNs 2.4 days, P=0.35). The omission of these agents did not increase estimated blood loss (116.6 cny CHNs 176.1 mL, P=0.8) or postoperaticny CHNe blood transfusion (0% cny CHNs 2.5%, P=0.17). Unicny CHNariate analysis demonstrated no association between use of fibrin sealants and increased complications (P>0.05). Multicny CHNariable logistic regression showed no statistically significant predicticny CHNe cny CHNalue of omission of hemostatic agents for perioperaticny CHNe outcomes (P>0.05). Conclusion: Perioperaticny CHNe hemorrhage and other major complications after contemporary RAPN are rare in experienced hands. In our study, the use of fibrin sealants during RAPN does not decrease the rate of complications, blood loss, or hospital stay. Furthermore, no impact is seen on operaticny CHNe time, WIT, or other negaticny CHNe outcomes. Omitting these agents during RAPN could be a safe, effecticny CHNe, cost-sacny CHNing measure.