Fibrin-thrombin sealant does not reduce lymphocele formation in patients with inguinofemoral lymphadenectomy for vulvar cancer

Inguinofemoral lymphadenectomy (IFLD) is associated with very high morbidity. Fibrin sealant patches are used in various surgical procedures to prevent hematomas and lymphoceles. Here, we report a single-institution experience of fibrin sealants after IFLD in vulvar cancer and give an overview of th...

Full description

Saved in:
Bibliographic Details
Published in:Cancer management and research 2019-01, Vol.11, p.3575-3582
Main Authors: Saner, Flurina Am, Schötzau, Andreas, Mackay, Gillian, Heinzelmann-Schwarz, Viola, Montavon Sartorius, Céline
Format: Article
Language:English
Subjects:
Biopsy
Breast cancer
Cancer patients
Care and treatment
Comparative analysis
Dissection
Fibrin
fibrin sealant
Genital cancers
Gynecological cancer
gynecological malignancy
Gynecology
Hospitals
Lymphatic system
Lymphedema
lymphovascular leakage
Medical prognosis
Medical research
Morbidity
Original Research
Penetrating wounds
Sealing compounds
Surgery
TachoSil
Thrombin
Time
Womens health
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Inguinofemoral lymphadenectomy (IFLD) is associated with very high morbidity. Fibrin sealant patches are used in various surgical procedures to prevent hematomas and lymphoceles. Here, we report a single-institution experience of fibrin sealants after IFLD in vulvar cancer and give an overview of the current literature. We retrospectively analyzed outcome data on vulvar cancer patients who underwent bilateral IFLD between November 2014 and June 2016 at the University Hospital Basel. A fibrin sealant patch (Tachosil ) was placed in one groin only. Postsurgical fluid collection and complications were compared between both groins; time courses of lymphocele formation were analyzed using a linear mixed-effects regression model. Postsurgical outcome of 11 consecutive patients with bilateral IFLD for vulvar cancer was assessed for a median follow-up of 32 days (range 12-77). Significantly larger lymphoceles were detected over time in the groin with the fibrin sealant patch (median 20 mL vs 5 mL without patch, =0.002), and more punctures for symptomatic lymphocele were required on this side. The infection rate did not differ between sides. Fibrin sealant patches should not routinely be used for prevention of lymphoceles after IFLD for vulvar cancer. They do not seem to reduce lymph collection, the need for puncture or the infection risk after lymphadenectomy in our experience and according to a general literature review.
ISSN:1179-1322
1179-1322
DOI:10.2147/CMAR.S197143