Comparison of the efficacy and histopathological effects of three hemostatic agents in a partial nephrectomy rat model

Abstract

Purpose The major complications of partial nephrectomy are bleeding and urine leakage. While various hemostatic agents are used to control bleeding, the histopathological characteristics of these hemostatic agents have not been investigated adequately. We aimed to investigate and compare the histopathological and hemostatic effects of local hemostatic agents in a partial nephrectomy rat model.

Methods Thirty-two rats were divided into four equal groups, and partial nephrectomy was done to all rats. Conventional suture repair, Glubran2 (R), FloSeal (R), and Celox (TM) were applied to every single group. The period of warm ischemia and hemostasis during surgical process was timed. Rats were killed later 3 weeks, and their partial nephrectomy applied kidneys were evaluated histopathologically.

Results The fastest hemostasis was provided with Glubran2 (R) (32.87 s). FloSeal (R) was the second (40.85 s), and Celox (TM) was the third (55.75 s). Glomerular necrosis and calcification were seen more in the suture group than other groups (p < 0.001). Fibrosis was found significantly less in Celox (TM) group. Fibroblast activation was found significantly less comparing to other groups (p < 0.01). The erythrocyte aggregation was significantly greater in the Glubran2 (R) and FloSeal (R) groups than suture group (p < 0.01 and p < 0.001).

Conclusion The negative effects of hemostatic agents to the renal histopathology were less than conventional suture repair. Celox (TM) was the best biocompatible agent. In comparison with three agents, it was observed that Glubran2 (R) provided hemostasis faster than other agents.