Applications of new bidirectional barbed free-knot suture in laparoscopic partial nephrecto my of hilar tumors

Chen Jie; Xu Bi you; Xu Danfeng; Cui Xingang; Gao Yi; Ren Jizhong; Yao Yac heng

Abstract：To eval uate safety and efficacy of the new bi directional barbed free- knot absorbable suture (QUI LL SRS )in laparoscopic partial nephrecto my of hilar tu mors .Methods :The clinical data of 1 0cases of laparo-scopicpartial nephrecto my for renal hilar tu mors were retrospectivel y anal yzed .All cases were gi ven QUI LL SRS to suture the ki dney .There were 6 males and 4 fe males withage ranging from 27 to 69 years (mean [47.5 ±1 9.3 ] years ).Tu mor dia meter was 1.5-4.7 cm (average [3.2 ±1.4 ]cm).There were 7 cases of ventral tu mor and 3 cases of dorsal tu mor .Nine cases suffered from single tu mor and one from bilateral renal tu mor .All patients were fallen into T1 N0 M0 by AJ CC TNMstaging preoperativel y .Results :LPN was successfull y operated on 1 0 cases .Operation time was 57-1 07 min with an average of (87.2 ±20.4 )min .Intraoperative bl ood l oss was 30-1 80 mL with an average of (55.0 ±42.8 )mL ,renal artery occl usion (war mische mia )time was 1 1-32 min with an average of (23.3 ±1 2.6 ) min .Suture time was 8-21 min with an average of (1 4.3 ±9.7 )min .Postoperative hospital stay was 5-8 d with an average of (6.5 ±1.3 )d .No renal pedicle vascular inj ury ,secondary bleeding ,urine leakage and other co mplications occurred .Postoperative bleeding and he maturia occurred in 1 case ,and recovered after conservative treat ment .Path-ol ogical findings were all Renal cell carcino ma was pathol ogicall y confir med ,and surgical margins were negative .Af-ter foll o w- up for 1-6 months ,no l ocal recurrence and distant metastasis occurred .Suture time and war m ische mia time were significantl y shorter ,the operation time was shorter ,and secondary he morrhage rate was less in LPNthan in control group .Conclusions :Use of new bi directional barbed free- knot suture in LPN for hilar tu mors can signifi-cantl y reduce the suture time and war m ische mia time ,which is conduci ve to the protection of renal function with good safety and feasibility .