Assessing the use of haemostatic sealants in tubeless percutaneous renal access and their effect on renal drainage and histology: an experimental porcine study

摘要: Objective To evaluate the mid-term effects of haemostatic sealant application during tubeless percutaneous nephrolithotomy (PCNL) on renal drainage and histology in an vivo porcine study. Materials Methods Bilateral access was established 28 units. At end procedure, a type 1 absorbable fish origin collagen powder, human fibrinogen- thrombin-coated sponge or cross-linked gelatin granule/topical thrombin matrix were randomly placed nephrostomy tracts. Four accesses left intact served as controls. No tube, ureteric stent bladder catheter place postoperatively. Computed tomography urography postoperative days 1, 15, 30 40 used to drainage. On day 40, all animals killed both kidneys from each animal harvested for histological evaluation. Results Evidence risk occlusion after found. The use sealants associated with significant lesions parenchyma, regardless which used. No identified superior others. Nephrostomy tracts that without (control group) no morbidity fewer histopathological changes. Conclusions Based these experimental results, safety PCNL should be reassessed, focusing not only potential such materials occlude urinary but also their effect histology. Further investigation is considered necessary.