J Gynecol Oncol.  2017 May;28(3):e37. 10.3802/jgo.2017.28.e37.

Prevention of lymphocele by using gelatin-thrombin matrix as a tissue sealant after pelvic lymphadenectomy in patients with gynecologic cancers: a prospective randomized controlled study

• Kim YH
• Shin HJ
• Ju W
• Kim SC

• KMID: 2413448
• DOI: http://doi.org/10.3802/jgo.2017.28.e37

Abstract

OBJECTIVE
This prospective randomized controlled pilot study aimed to find whether gelatin-thrombin matrix used as a tissue sealant (FloSeal) can prevent the occurrence of pelvic lymphocele in patients with gynecologic cancer who has undergone pelvic lymphadenectomy.
METHODS
Each patient, who undergo a laparotomic pelvic lymph node dissection on both sides, was randomly assigned for FloSeal application on 1 side of the pelvis. The other side of the pelvis without any product application being the control side. The amount of lymph drainage at each side of the pelvis was measured for 3 days, and computed tomography scans were obtained 7 days and 6 months after surgery for detection of pelvic lymphocele.
RESULTS
Among 37 cases, the median amount of lymph drainage was significantly decreased in the hemi-pelvis treated with FloSeal compared to the control hemi-pelvis (p=0.025). The occurrence of lymphocele was considerably reduced in treated hemi-pelvis (8/37, 21.6%) compared with control hemi-pelvis (12/37, 32.4%) after 7 post-operative days (p=0.219), and more decreased in the treated hemi-pelvis (5/37, 13.5%) compared with control hemi-pelvis (9/37, 24.3%) after postoperative 6 months (p=0.344).
CONCLUSION
The application of FloSeal as a tissue sealant in lymph nodes resected tissues can reduce the incidence of pelvic lymphocele in gynecologic cancer patients. A large randomized controlled study could confirm these preliminary results.

Keyword

Genital Neoplasms, Female; Lymphocele; Drainage; Secondary Prevention; Lymph Node Excision; Surgical Oncology

MeSH Terms

Adult
Aged
Drainage
Female
Gelatin Sponge, Absorbable/*therapeutic use
Genital Neoplasms, Female/*surgery
Humans
Lymph Node Excision/*adverse effects/methods
Lymphocele/*prevention & control
Middle Aged
Pelvis/surgery
Pilot Projects
Postoperative Complications/*prevention & control
Prospective Studies

Figure

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  Fig. 1. Flow chart of participating patients presented by the Consolidated Standards of Reporting Trials diagram.

Reference

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