PT  - JOURNAL ARTICLE
AU  - Andrea Tinelli
AU  - Ospan A. Mynbaev
AU  - Daniel Alberto Tsin
AU  - Giorgio Giorda
AU  - Antonio Malvasi
AU  - Marcello Guido
AU  - Farr R. Nezhat
TI  - Lymphocele Prevention After Pelvic Laparoscopic Lymphadenectomy by a Collagen Patch Coated With Human Coagulation Factors: A Matched Case-Control Study
AID  - 10.1097/IGC.0b013e31828eeea4
DP  - 2013 Jun 01
TA  - International Journal of Gynecologic Cancer
PG  - 956--963
VI  - 23
IP  - 5
4099  - http://ijgc.bmj.com/content/23/5/956.short
4100  - http://ijgc.bmj.com/content/23/5/956.full
SO  - Int J Gynecol Cancer2013 Jun 01; 23
AB  - Objective Lymphoceles are among the most common postoperative complications of pelvic lymphadenectomy (PL), with a reported incidence of 1% to 50%. Symptoms are pelvic pain, leg edema, gastrointestinal obstruction, obstructive uropathy, and deep vein thrombosis, and severe complications such as sepsis and lymphatic fistula formation. After laparoscopic PL, we tested the prevention of lymphoceles using collagen patch coated with the human coagulation factors (TachoSil, Nycomed International Management GmbH, Zurich, Switzerland) on 55 patients with endometrial cancer stages IB to II who had undergone laparoscopy.Materials and Methods The authors divided the patients into 2 laparoscopy groups: PL plus TachoSil (group 1: 26 patients) and PL without TachoSil in a control group (group 2: 29 patients), as historical cohort of patients who underwent PL between 2010 and 2012. We collected surgical parameters, and the 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 The same number of lymph nodes in both groups was removed; group 1 showed a lower drainage volume. Lymphoceles developed in 5 patients in group 1 and in 15 patients in group 2; of these, only 2 patients were symptomatic in group 1 and 5 patients were symptomatic in group 2, without statistical difference and no percutaneous drainage request.Conclusions In this preliminary investigation, the intraoperative laparoscopy application of TachoSil seems to reduce the rate of postoperative lymphoceles after PL, providing a useful additional treatment option for reducing drainage volume and preventing lymphocele development after PL.