Comparison of herbal-based and synthetic hemostatic agents for efficacy on a rat partial nephrectomy model. Experimental study.

OBJECTIVE To compare the efficacy of herbal based and synthetic hemostatic agents in partial nephrectomy. METHODS Our experimental study was carried out at the Ankara Training and Research Hospital, Ankara, Turkey between May and November 2012. Twenty rats were randomly divided into 4 groups. Intracorporeal sutures (group K), TachoSil (group T), HaemoCer (group H), and Ankaferd Blood Stopper (group A) were used to achieve hemostasis in partial nephrectomy. Warm ischemia time (WIT), hemostasis time (HT), and blood loss for all groups were measured. The specimens were examined histopathologically and electron microscopically after sacrificing the rats. RESULTS The fastest hemostasis was detected in group T, followed by group H, and group A. The WIT and HT were significantly different for all groups (p<0.001). The greatest blood loss was found in group K. The histopathologic examination revealed that the giant cell reaction in group K was significantly more than in group H and group A (p<0.001). No pathologic findings were observed in the ultrastructural examination of specimens taken from group K. On ultrastructural examination of group T, tubule cells had many vacuoles in their cytoplasm with marked intracellular edema. Ultrastructural findings for groups H and A were similar. CONCLUSION At the histopathologic and ultrastructural levels, herbal-based hemostatic agents had a positive impact on renal tissue and glomerular function when applied during partial nephrectomy.