The Use of Self-Retaining Barbed Suture Preserves Superior Renal Function During Laparoscopic Partial Nephrectomy: A PADUA Score Matched Comparison

Introduction: To evaluate the efficacy and safety of self-retaining barbed suture (SRBS) application during laparoscopic partial nephrectomy (LPN), by assessing perioperative outcomes. Materials and Methods: Data from consecutive patients who underwent retroperitoneal LPN from January 2008 to December 2013 were retrospectively collected. Patients were divided into two groups according to suture techniques for renorrhaphy: the sliding clip technique and SRBS. The SRBS cases (Group 2 [G2]) were 1:1 matched with cases in the sliding clip group (Group 1 [G1]) for the PADUA score. Patient characteristics, perioperative outcomes, and renal function changes were compared between the groups. Results: In total, 41 patients in G1 and 41 patients in G2 successfully underwent LPN. Patient characteristics, operative time, and complication rate were similar for both groups. Mean warm ischemia time was significantly shorter for the SRBS group (G1 versus G2, 27.5 versus 20.7 minutes; P<.05). The estimated blood loss was similar in both groups. An improved early affected renal function recovery was observed in the SRBS group (percentage of glomerular filtration rate reduction for G1 versus G2, 29% versus 20.8%; P<.05). Conclusions: The SRBS application offers an effective and safe renal parenchyma repair. In addition, SRBS appears to significantly minimize the warm ischemia injury and results in superior short-term renal function preservation.