Randomized, Prospective Evaluation of Hemostatic Agents in Robotic-Assisted Laparoscopic Partial Nephrectomy

PURPOSE: Hemostatic agents (HAs) are typically used during robotic-assisted laparoscopic partial nephrectomy (RALPN) to minimize perioperative bleeding. However, high-quality evidence supporting their effectiveness is limited. We aimed to determine whether HAs reduce perioperative blood loss in patients undergoing RALPN. MATERIALS AND METHODS: We conducted a prospective, randomized controlled trial of patients undergoing RALPN. Patients were randomized to HA+, in which HAs were assigned, and HA-, no HA. The primary end point was mean change in hemoglobin from preoperative baseline to postoperative day 1. Secondary outcomes included major bleeding complications (blood transfusion, reoperation, and endovascular intervention), length of stay, and 30-day readmission. RESULTS: = .7, 95% CI for group difference: [-5.4%] to 9.8%), as 4 patients (4.5%) in the HA- group and 6 patients (6.7%) in the HA+ experienced major bleeding complications. CONCLUSIONS: Routine use of HAs during RALPN does not seem to lower the risk for bleeding after surgery, as measured by the change in hemoglobin levels or major bleeding complications.