|
|
Back to MAAUA Scientific Program
Application of Fibrin Sealant at the Urethrovesical Anastamosis in Robotic-assisted Radical Prostatectomy: Does it Enable Earlier Foley Catheter and Jackson Pratt Drain Removal?
Sarah C Flury, Danille N Starnes, Willaim D. Steers
UVA, Charlottesville, VA
Introduction: After robotic assisted laparascopic prostatectomy (RALRP), leakage at the urethrovescial anastamosis in the immediate postoperative period can occur and cause ileus. We examined the effectiveness of using a fibrin sealant at the anastamosis to eliminate urine leakage and facilitate earlier Jackson Pratt drain and Foley catheter removal.
Methods: 40 consecutive patients underwent RALRP by one surgeon at our institution. The first 20 pateints underwent standard operation and served as the control group. The subsequent 20 patients underwent the same operation with addition of fibrin sealant following a running absorbable sutured urethrovesical anastamosis.
Results: The two groups were compared for age (60.5 vs 58.2 yrs), pre-operative PSA (5.23 vs. 4.71), Gleason Score (6.3 vs. 6.5), and prostate size at resection (51.7g vs. 47.7g). Wilcoxon Rank Sum test determined no statistically significant differences in the groups. Patients in the fibrin sealant group had 1.3 vs. 2.1 days with a Jackson Pratt drain, 9.75 vs. 12.1 days with a catheter, and an average of 38.6 cc vs. 63.2 cc per shift of drainage. Catheters were removed when a cystogram demonstrated no extravasation of contrast. Two patients in the control group and no patients in the fibrin sealant group had large volume leakage post-operatively.
Conclusions: Application of fibrin sealant at the urethrovesical anastamosis appears to facilitate sealing thereby allowing earlier removal of JP drain by 0.8 days and Foley catheter by 2.35 days than controls in patients undergoing RALRP. This adjunct may be especially useful early in the learning process to reduce morbidity.
Back to MAAUA Scientific Program
|
|
