[Does administration of fibrin glue prevent development of lymphoceles after radical lymphadenectomy?].

Abstract

Surgical approaches to the groin and axilla, almost radical lymph node dissections (RLND) are followed frequently by lymphocysts. In a prospective randomized study of 30 inguinal or axillary RLND we used at half of the cases 1 ml of the two-component fibrin glue (Tissucol), applied as a spray to seal the wound at the end of the operation. At 27 patients not only a prophylactic RLND but a selective hyperthermic cytostatic perfusion of the extremity was performed because of a locally advanced malignant tumor. There was no difference between the two groups of patients in age, diagnosis, surgical technique, and follow-up. In two cases of the fibrin glue (FG)-group and in 4 cases of the control group a second intervention because of a local wound healing problem had to be performed. The mean amount of postoperative drainage fluid was 1065 +/- 822 ml at the FG-group and 1332 +/- 1093 ml at the control group. Also postoperative drainage time (9 vs. 12 days) and postoperative hospital stay (18 vs. 22 days) were shorter at the FG-group, however, without statistical significance. 11 of 14 patients of the FG-group and 10 of 14 patients of the control group had normal scars after lymphadenectomy without signs of lymphocysts at the clinical follow-up. At our high risk patients (very high amount of postoperative drainage fluid in comparison to other series) prophylactic fibrin glue sealing after RLND could not prevent lymphocysts and lymphatic fistulae.

• Authors: M Furrer, R Inderbitzi, B Nachbur
• Journal: Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen (Chirurg) Vol. 64 Issue 12 Pg. 1044-9 (Dec 1993) ISSN: 0009-4722 [Print] Germany
• Vernacular Title: Verhindert die Applikation von Fibrinkleber die Entwicklung von Lymphocelen nach radikalen Lymphadenektomien?
• PMID: 8119091 (Publication Type: Clinical Trial, English Abstract, Journal Article, Randomized Controlled Trial)

Chemical References

• Fibrin Tissue Adhesive

Topics

• Adult
• Aged
• Aged, 80 and over
• Axilla (surgery)
• Drainage
• Extremities (surgery)
• Female
• Fibrin Tissue Adhesive (administration & dosage)
• Follow-Up Studies
• Humans
• Inguinal Canal (surgery)
• Lymph Node Excision (methods)
• Lymph Nodes (pathology)
• Lymphocele (pathology, prevention & control)
• Male
• Melanoma (pathology, surgery)
• Middle Aged
• Postoperative Complications (pathology, prevention & control)
• Prospective Studies
• Skin Neoplasms (pathology, surgery)
• Wound Healing (drug effects)