The Impact of Gelatin-Sealant in the Access Tract after Tubeless Percutaneous Nephrolithotomy: A Randomized Controlled Trial
Sakolrat Titaram MD*, Chaiyong Nualyong MD*, Tawatchai Taweemonkongsap MD*, Siros Jitpraphai MD*, Ekkarin Chotikawanich MD*
Affiliation : * Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : To determine safety and efficacy of gelatin-sealant filled in the access tract after tubeless percutaneous nephrolithotomy
(PCNL).
Material and Method: A randomized control trial study. 82 patients were divided into 2 groups, 41 patients for each group
of with and without gelatin-sealant filled in the access tract. Changing of hemoglobin, blood transfusion, and post-operative
complications were compared.
Results : Decreasing of hemoglobin was 1.2 g/dl in group of gelatin-sealant and 1.5 g/dl in the other (p = 0.26). Blood
transfusion was less in gelatin-sealant group than the other (2 units vs. 4 units, p = 0.63). Urethral catheter time was shorter
in gelatin-sealant group (2 days vs. 3 days, p = 0.02). Others were not different.
Conclusion : Gelatin-sealant in access tract after tubeless PCNL is safe to be an option to prevent bleeding in selected
patients.
Keywords : tubeless PCNL, gelfoam, gelatin sealant hemostatic agent, postoperative bleeding
