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.
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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.
