TY - JOUR
T1 - Prevention of lymphocele in female pelvic lymphadenectomy by a collagen patch coated with the human coagulation factors
T2 - A pilot study
AU - Tinelli, Andrea
AU - Giorda, Giorgio
AU - Manca, Corrado
AU - Pellegrino, Marcello
AU - Prudenzano, Raffaele
AU - Guido, Marcello
AU - Dell'Edera, Domenico
AU - Malvasi, Antonio
PY - 2012/6/15
Y1 - 2012/6/15
N2 - Background and Objectives The prevention of lymphoceles was tested using collagen patch coated with the human coagulation factors (TachoSil) on 58 consecutive patients with endometrial cancer who had undergone hysterectomy and pelvic lymphadenectomy (PL). Methods Patients were randomized in two groups: standard technique plus TachoSil (30 patients, group 1) and standard technique only (28, group 2). All surgical parameters were collected and patients underwent ultrasound examination on postoperative days 7, 14, and 28. The main outcome measures were: the development of symptomatic or asymptomatic lymphoceles, the need for further surgical intervention, as adverse effect of surgery and the drainage volume and duration. Results Same number of lymph nodes in both groups was removed; group 1 showed a lower drainage volume. Lymphoceles developed in 7 patients in group 1 and 16 in group 2, but only 3 were symptomatic in group 1 and 9 symptomatic in group 2, with statistical difference. Percutaneous drainage proved necessary in five cases: only one was in group 1 and four in group 2. Conclusions Intraoperative application of TachoSil reduced rate of postoperative lymphocysts after PL, and it seems to provide a useful additional treatment option for reducing drainage volume and preventing lymphocele development after PL.
AB - Background and Objectives The prevention of lymphoceles was tested using collagen patch coated with the human coagulation factors (TachoSil) on 58 consecutive patients with endometrial cancer who had undergone hysterectomy and pelvic lymphadenectomy (PL). Methods Patients were randomized in two groups: standard technique plus TachoSil (30 patients, group 1) and standard technique only (28, group 2). All surgical parameters were collected and patients underwent ultrasound examination on postoperative days 7, 14, and 28. The main outcome measures were: the development of symptomatic or asymptomatic lymphoceles, the need for further surgical intervention, as adverse effect of surgery and the drainage volume and duration. Results Same number of lymph nodes in both groups was removed; group 1 showed a lower drainage volume. Lymphoceles developed in 7 patients in group 1 and 16 in group 2, but only 3 were symptomatic in group 1 and 9 symptomatic in group 2, with statistical difference. Percutaneous drainage proved necessary in five cases: only one was in group 1 and four in group 2. Conclusions Intraoperative application of TachoSil reduced rate of postoperative lymphocysts after PL, and it seems to provide a useful additional treatment option for reducing drainage volume and preventing lymphocele development after PL.
KW - complications
KW - drainage
KW - endometrial cancer
KW - lymph nodes
KW - lymphocele
KW - lymphocysts
KW - pelvic lymphadenectomy
KW - pelvis
KW - radical hysterectomy
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U2 - 10.1002/jso.22110
DO - 10.1002/jso.22110
M3 - Article
C2 - 21987409
AN - SCOPUS:84861099219
VL - 105
SP - 835
EP - 840
JO - Journal of Surgical Oncology
JF - Journal of Surgical Oncology
SN - 0022-4790
IS - 8
ER -