BACKGROUND - Perioperative bleeding is a potential complication of robot-assisted laparoscopic radical prostatectomy (RALP) that may worsen outcomes. The role of local hemostatic materials in RALP has not been adequately assessed.
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We evaluated the hemostatic impact of FloSeal (Baxter International Inc. , Fremont, Calif. , USA) in RALP.
METHODS - A retrospective analysis was performed of 392 consecutive patients with prostate cancer who underwent RALP at our institution between February 2008 and July 2014. The patients were divided into 2 consecutive homogenous groups based on the use of FloSeal. Group A included 200 patients who underwent RALP between February 2008 and May 2011, with hemostasis performed using only traditional techniques. Group B included the remaining 192 patients, who underwent RALP between June 2011 and July 2014 and received FloSeal 5 ml after traditional hemostatic methods. We compared the blood transfusion rate, the differences between immediate postoperative hemoglobin (Hb) and mean postoperative day 1 (POD1) Hb levels, difference between POD1 and least Hb levels and difference between immediate postoperative Hb and least Hb levels.
RESULTS - The intraoperative use of FloSeal significantly decreased the blood transfusions rate, from 8. 5 to 2. 1% (p = 0. 004). FloSeal was also associated with significant improvements in the difference between the immediate postoperative Hb and POD1 Hb levels (p = 0. 03), mean POD1 Hb and least Hb (p = 0. 01) and mean immediate postoperative Hb and least Hb levels (p = 0. 034).
CONCLUSIONS - In this study, the use of FloSeal improves hemostatic outcomes in patients undergoing RALP compared with traditional hemostatic techniques, without increase of cost.
Urologia internationalis. 2016 Feb 19 [Epub ahead of print]
Eugenio Martorana, Ahmed Ghaith, Salvatore Micali, Giacomo Maria Pirola, Cosimo De Carne, Francesco Fidanza, Giampaolo Bianchi
Department of Urology, University of Modena and Reggio Emilia, Modena, Italy.