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The Efficacy of Fibrin Sealant Patches in Reducing the Incidence of Lymphatic Morbidity After Radical Lymphadenectomy: A Meta-Analysis
  1. Maria Luisa Gasparri, MD*,,
  2. Ilary Ruscito, MD*,
  3. Daniele Bolla, MD,
  4. Pierluigi Benedetti Panici, MD*,
  5. Michael D. Mueller, MD and
  6. Andrea Papadia, MD, PhD
  1. * Department of Gynecology, Obstetrics and Urology, Sapienza University of Rome, Rome, Italy; and
  2. Department of Obstetrics and Gynecology, University Hospital of Berne, University of Berne, Berne, Switzerland.
  1. Address correspondence and reprint requests to Ilary Ruscito, MD, Department of Gynecology, Obstetrics and Urology, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy. E-mail: ilary.ruscito{at}uniroma1.it.

Abstract

Background Although pivotal in the oncological management of most tumors, radical lymphadenectomy is associated with a significant number of lymphatic complications. The aim of this meta-analysis is to evaluate the efficacy of fibrinogen sealant patches in reducing lymphadenectomy-related postoperative complications.

Methods/Materials The electronic databases PubMed, Medline, and Scopus were searched using the terms “lymphadenectomy” or “lymph node dissection” and “TachoSil,” “TachoComb,” or “fibrin sealant patch.” Series evaluating the efficacy of fibrin-thrombin collagen sealant patches were included in the meta-analysis.

Results Overall, 26 studies were retrieved through the literature search. Ten studies including 720 patients met selection criteria. The use of fibrin-thrombin sealant patches to the sole scope of reducing lymphadenectomy-related complications significantly reduced the incidence of lymphocele, symptomatic lymphocele, the need of percutaneous drainage procedures, the volume of lymph drained, and the duration of the drainage. No effect on wound and/or lymphocele infection was noted.

Conclusions This meta-analysis demonstrates that the use of fibrin-thrombin sealant patches significantly reduces the total volume of lymph drained, the duration of the drainage, the incidence of lymphocele and symptomatic lymphocele, and the need for postoperative percutaneous drainage procedures. Its use does not affect the incidence of wound or lymphocele infections.

  • Fibrin sealant patch
  • Lymphadenectomy
  • Lymphocele
  • TachoComb
  • TachoSil

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Footnotes

  • The authors declare no conflicts of interest.

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