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According to an article recently published in the journal Urology, the use of a tissue adhesive (BioGlue) appears to reduce the risk of blood transfusions and lessens blood loss compared to the use of stitches during surgery for kidney cancer.

The kidneys are a pair of bean-shaped organs located on each side of the spine. The kidneys filter the blood and eliminate waste in the urine through a complex system of filtration tubules. All of the blood in the body passes through the kidneys approximately 20 times an hour. Renal cell cancer is an uncommon form of cancer that is most often characterized by the presence of cancer cells in the lining of the filtration tubules of the kidney.

Early renal cell cancer (RCC) refers to cancer that has not spread far from the site of origin. Some early RCCs can be removed surgically.

Surgeons may attempt to spare part of the kidney while removing only the portion containing the cancer. This procedure is referred to as a partial nephrectomy and may cure patients with early RCC.

However, some elderly patients and those with other existing medical conditions may not be eligible for surgery. Researchers are evaluating ways to make surgery easier to tolerate for these patients.

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Researchers from Israel recently conducted a clinical study to evaluate BioGlue (albumin glutaraldehyde tissue adhesive)-a tissue adhesive used instead of stitches to seal tissue together after surgery. This study included 174 patients who underwent a partial nephrectomy for the treatment of early RCC between 1993 and 2005. Thirty-one patients underwent surgery with BioGlue and without stitches (sutures), while 143 had surgery with the standard use of sutures.

  • The mean blood loss for patients treated with BioGlue was 45.1 mL compared with 111.7 mL for those treated with standard sutures.
  • Blood transfusions were required in only one patient treated with BioGlue compared with 17% of patients treated with standard sutures.
  • No patients treated with BioGlue developed a urinary fistula (abnormality in any urinary tract organ) compared with 2% of patients treated with sutures.
  • The average duration of surgery was reduced in patients treated with BioGlue versus those treated with sutures.

The researchers concluded that tissue adhesive such as BioGlue appears to reduce complications from surgery compared with standard sutures in patients with early RCC undergoing a partial nephrectomy. Future study is necessary to determine the true effectiveness of BioGlue in surgical procedures, as well as its potential effects on outcomes.

Reference: Hidas G, Kastin A, Mullerad M, et al. Sutureless Nephron-Sparing Surgery: Use of Albumin Glutaraldehyde Tissue Adhesive (BioGlue). Urology. 2006; 67: 697-700.

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