Prophylactic periprostatic hemostatic sutures significantly decrease intraoperative blood loss during open radical retropubic prostatectomy (RRP), a study found.
In 2007, William J. Catalona, MD, Professor of Urology at Northwestern University Feinberg School of Medicine in Chicago, and colleagues began placing prophylactic hemostatic sutures of 4-0 and 3-0 catgut in the anterior portions of the distal neurovascular bundles (NVBs) and lateral to the proximal NVBs and prostate pedicles before starting nerve-sparing dissection and mobilizing of the prostate.
The researchers compared estimated blood loss (EBL), non-autologous transfusion rates, and postoperative hemoglobin levels between 100 consecutive patients treated immediately before and 100 consecutive patients treated immediately after introduction of the suturing technique.
The mean intraoperative EBL decreased significantly from 1,285 mL in the no-suturing group to 700 mL in the suturing group, the investigators reported in BJU International (2009; published online ahead of print).
One patient in the no-suturing group and no patient in the suturing group required an intraoperative non-autologous transfusion. The mean hemoglobin level the morning after RRP was 10.9 g/dL in the no-suturing group compared with 11.8 g/dL in the suturing group, a significant difference between the groups.