{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T01:06:04Z","timestamp":1759971964248,"version":"build-2065373602"},"reference-count":34,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,8,16]],"date-time":"2023-08-16T00:00:00Z","timestamp":1692144000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJUI Compass"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aimed to determine if using a pre\u2010gerotal fat patch at open partial nephrectomy (PN) as a haemostatic bolster is a viable alternative to using synthetic haemostatic agents.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>Human Research Ethics Committee approval was obtained for audit of a prospectively kept database from July 2012 to July 2021, which followed outcomes of patients who received a low\u2010tension pre\u2010gerotal fat patch renorrhaphy at open PN. Patient demographics, intraoperative measures, histological outcomes and post\u2010operative complications were analysed. Using a retroperitoneal approach, the peritoneum was mobilised and a vascularised pedicle of pre\u2010gerotal fat was rotated in the direction of the kidney. Routine definition of the hilum, clamping of the hilar vessels and dissection of mass followed. After watertight closure and haemostasis, the harvested pre\u2010gerotal fat patch was placed over the defect and secured using low\u2010tension renorrhaphy. Two\u2010layer closure of the abdominal wall with placement of a drain was routine.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 55 patients underwent open PN. Mean age was 60.4 (35\u201377) years. There were 38 men and 17 women, and 32 right and 23 left PNs. Mean mass size was 31.9\u2009mm (10\u201395\u2009mm) and collecting system was breached in 36.5% of cases. One patient (1.9%) suffered a Clavien\u2013Dindo IIIb complication requiring return to theatre and transfusion due to a bleed from an intercostal artery. There were no renal bed bleeds, urine leaks or urine fistulas detected. Mean intraoperative blood loss was 355\u2009mL (50\u20131500\u2009mL) and mean post\u2010operative creatinine increased by 10.7\u2009\u03bcmol\/L (51\u2013172\u2009\u03bcmol\/L). Mean follow up was 40.2 (4\u2013109) months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Utilisation of an anatomical pre\u2010gerotal fat patch to provide pressure at the renorrhaphy site during open PN is an effective technique to assist with surgical haemostasis. This simple technique avoids the costs of haemostatic agents, whilst adding minimal operating time to procedures.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bco2.264","type":"journal-article","created":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T00:49:44Z","timestamp":1692233384000},"page":"709-714","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pre\u2010gerotal fat patch\u2014A novel alternative to haemostatic agents during partial nephrectomy"],"prefix":"10.1002","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6195-3364","authenticated-orcid":false,"given":"Brennan","family":"Timm","sequence":"first","affiliation":[{"name":"Bunbury Regional Hospital  Bunbury Western Australia 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