A Comparison Of The Clinical Effects Between Two Different Suture Methods In Laparoscopic Partial Nephrectomy

[Objectives]To explore the efficacy and safety of the barbed suture in laparoscopic partial nephrectomy.[Methods]A total of 128 consecutive patients underwent laparoscopic partial nephrectomy by a single experienced surgeon from June 2013 to December 2015 in Urology Surgery of Qilu Hospital were included. Stratifying 128 patients into two groups:67 patients were operated with barbed suture and 61 patients with traditional absorbable suture. Perioperative parameters like general data, radius and location of renal mass, R.E.N.A.L scores, ASA scores, surgery duration, warm ischemia time, hospital stay, renal function and complications were analyzed and compared; meanwhile, subgroup analysis was conducted for further study.[Results]All 128 cases were performed successfully, and no significantly statistical differences (P>0.05) were found between the two groups in general data, the mean radius of renal masses, postoperative complication incidence, mean hospital stay and mean suture cost. However there were significantly statistical differences (P<0.05) in mean warm ischemia time (15.3±7.2 min vs.22.9±6.7min, P<0.001), especially in complex renal tumor (17.4±8.0min vs.25.9±7.4min,P<0.001)and the mean operative time(98.3±32.9min vs.112.6±29.5 min, P=0.216)、the mean estimated blood loss(136.5±102.0 ml vs.176.3±101.2 ml, P=0.072) and the mean percentage of eGFR reduction in barbed suture group showed a better efficacy than the other group, but the statistical differences were not significant.[Conclusions]Barbed suture in laparoscopic partial nephrectomy is combined with shorter warm ischemia time especially in complex renal tumor; and there are no significantly statistical differences between two groups in operative time、estimated blood loss and protecting renal function; thus it simplifies the laparoscopic technique and confirms a fine efficiency in laparoscopic partial nephrectomy...