The Use of a Surgical Patch in the Prevention of Lymphoceles After Extraperitoneal Pelvic Lymphadenectomy for Prostate Cancer: A Randomized Prospective Pilot Study

Alchiede Simonato, Virginia Varca, Marco Esposito, Fabio Venzano, Giorgio Carmignani

Research output: Contribution to journalArticle

53 Citations (Scopus)

Abstract

Purpose: Pelvic lymphadenectomy is frequently performed simultaneously with radical prostatectomy to determine lymph node status and the most frequently recorded postoperative complication is the development of a symptomatic lymphocele. This study evaluated TachoSil® as an adjunct treatment in preventing lymphoceles after extraperitoneal pelvic lymphadenectomy for prostate cancer. Materials and Methods: A total of 60 consecutive patients who had undergone radical prostatectomy and pelvic lymphadenectomy were prospectively enrolled in this study. The patients were randomly assigned to a standard technique with the use of clips and electrocoagulation plus TachoSil, or to standard technique only. All patients underwent ultrasound examination on postoperative days 7, 14 and 28 to test for the development of symptomatic or asymptomatic lymphoceles. Drainage volume and duration were also recorded. Results: The baseline characteristics of the 2 randomized groups were well matched. Those patients in whom we used TachoSil showed a lower drainage volume with a mean total volume of 64 ± 45 ml (range 0 to 110) vs 190 ± 62.72 ml (range 70 to 270, p = 0.009), and had significantly fewer symptomatic and asymptomatic lymphoceles (5 vs 19, p = 0.001). Only 5 percutaneous surgical procedures to drain the lymphoceles proved necessary, 1 of which occurred in the group with TachoSil. Conclusions: TachoSil seems to provide a useful additional treatment option for reducing drainage volume and preventing lymphocele development after extraperitoneal radical retropubic prostatectomy with pelvic lymphadenectomy.

Original languageEnglish
Pages (from-to)2285-2290
Number of pages6
JournalJournal of Urology
Volume182
Issue number5
DOIs
Publication statusPublished - Nov 2009

Fingerprint

Lymphocele
Lymph Node Excision
Prostatic Neoplasms
Prospective Studies
Prostatectomy
Drainage
Electrocoagulation
Surgical Instruments
Lymph Nodes
TachoSil
Therapeutics

Keywords

  • complications
  • lymph node excision
  • lymphocele
  • pelvis
  • prostatectomy

ASJC Scopus subject areas

  • Medicine(all)
  • Urology

Cite this

The Use of a Surgical Patch in the Prevention of Lymphoceles After Extraperitoneal Pelvic Lymphadenectomy for Prostate Cancer : A Randomized Prospective Pilot Study. / Simonato, Alchiede; Varca, Virginia; Esposito, Marco; Venzano, Fabio; Carmignani, Giorgio.

In: Journal of Urology, Vol. 182, No. 5, 11.2009, p. 2285-2290.

Research output: Contribution to journalArticle

Simonato, Alchiede ; Varca, Virginia ; Esposito, Marco ; Venzano, Fabio ; Carmignani, Giorgio. / The Use of a Surgical Patch in the Prevention of Lymphoceles After Extraperitoneal Pelvic Lymphadenectomy for Prostate Cancer : A Randomized Prospective Pilot Study. In: Journal of Urology. 2009 ; Vol. 182, No. 5. pp. 2285-2290.
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