The effects of low-thrombin fibrin sealant on wound serous drainage, seroma formation and length of postoperative stay in patients undergoing axillary node dissection for breast cancer. A randomized controlled trial

Benevento, Raffaella; Santoriello, A; Pellino, Gianluca; Sciaudone, Guido; Candilio, Giuseppe; Fatico, G. Serena De; Selvaggi, Francesco; Canonico, Silvestro

doi:10.1016/j.ijsu.2014.10.005

Cited by 37 publications

(25 citation statements)

References 38 publications

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“…This provides further support to the findings of a meta‐analysis that investigated the outcomes associated with the use of fibrin sealants in head and neck surgery . In addition, our findings are consistent with a previous randomised control trial investigating the use of Artiss™ vs drain alone in breast cancer patients undergoing axillary node clearance . That study noted, in similar findings to our results, a significant reduction in total volume drained and length of stay in hospital.…”

Section: Discussionsupporting

confidence: 92%

An audit of fifty patients receiving Artiss™ fibrin sealant in lateral selective neck dissections

Earnshaw

Kinshuck

Loh

et al. 2019

Clinical Otolaryngology

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Section: Discussionsupporting

confidence: 92%

An audit of fifty patients receiving Artiss™ fibrin sealant in lateral selective neck dissections

Earnshaw

Kinshuck

Loh

et al. 2019

Clinical Otolaryngology

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“…The sealant has been proposed to reduce the incidence and volume of seromas following various surgeries, such as rhytidectomy and cardiovascular surgery, by obliterating the potential space between tissue layers . When used with drainage, the sealant has been shown to reduce the amount of serous fluid produced in the axilla after breast surgery, but there are no data regarding the use of Artiss alone …”

Section: Introductionmentioning

confidence: 99%

“…[14][15][16][17] When used with drainage, the sealant has been shown to reduce the amount of serous fluid produced in the axilla after breast surgery, but there are no data regarding the use of Artiss alone. 18 There is mounting evidence supporting the safety and feasibility of day-case breast surgery. [19][20][21] Day case is defined as the discharge of patient from hospital by midnight on the day of surgery.…”

Section: Introductionmentioning

confidence: 99%

Increasing the incidence of drain‐free day‐case mastectomies with the use of a fibrin tissue sealant; data from a single surgical center in the United Kingdom

et al. 2019

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Day‐case mastectomy surgery provides benefits to both patients and hospitals. Key barriers are the use of a drain and the risk of postoperative seroma formation. We introduced the use of a tissue sealant (Artiss) into the surgical site (post‐mastectomy without immediate reconstruction and postaxillary clearance) and evaluated its effect on our practice, particularly day‐case rates. A prospective audit of 177 patients who underwent a simple mastectomy with or without axillary surgery, or axillary node clearance with or without breast‐conserving surgery was conducted at a single surgical center in the UK between November 2015 and November 2016. Artiss was used in all operations and, where appropriate, the drain was omitted to facilitate day‐case surgery. The clinical outcomes were compared between patients undergoing different operations and duration of hospital stay. There was no statistically significant difference between day‐case patients and inpatients in seroma aspiration rates (24.5% and 21.7%, respectively; P = 0.381) or other complications (22.4% and 16.1%, respectively; P = 0.106). The day‐case mastectomy rate increased from 3.9% in the first quarter to 45.5% in the final quarter, which was a significant increase reaching well beyond the national target. The use of Artiss enabled us to increase the drain‐free day‐case surgery rates over a 1‐year period, exceeding the 30% target recommended by the British Association of Day Surgery. We did not observe any increase in patient morbidity, and the change was cost‐effective. We have now implemented the routine use of Artiss in women undergoing simple mastectomy with or without axillary surgery and stand‐alone axillary node clearances as part of enhanced recovery clinical pathways.

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“…In 9 patients, we used fibrin glue to reduce postoperative lymphorrhea, but it was not used in this case. Several prospective studies have addressed the use of a fibrin sealant to reduce lymphadenectomy-related postoperative complications in patients undergoing dissection of the groin, axilla, or paraaortic lesions [2122232425]. However, these results remain controversial.…”

Section: Discussionmentioning

confidence: 99%

Advantage of urological experience with both transperitoneal and retroperitoneal laparoscopy in lymph node biopsy for malignant lymphoma diagnosis

et al. 2016

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PurposeLaparoscopic urologists are familiar with both transperitoneal and retroperitoneal approaches. That experience is an advantage when devising a strategy for intra-abdominal lymph node biopsy. We report the feasibility and effectiveness of laparoscopic biopsy using a urological laparoscopic technique for the treatment of patients with clinically suspected intra-abdominal lymphoma.Materials and MethodsFrom October 2010 to April 2015, a total of 22 patients underwent laparoscopic biopsy for suspected intra-abdominal lymphoma. We adopted a retroperitoneal approach for paraaortic or paracaval masses, whereas we used a transperitoneal approach for mesenteric, iliac, or obturator masses. Whenever possible, an entire node was removed; otherwise, the biopsy consisted of wedge resection sized at least 1 cm3.ResultsBiopsy specimens were obtained from the following lymph node sites: 10 paraaortic, 5 paracaval, 3 mesenteric, 2 obturator, 1 common iliac, and 1 perinephric fat. Laparoscopic lymph node biopsy was completed in all patients, and there were no conversions to open surgery. The median operating time was 97 minutes (range, 62–167 minutes). The estimated blood loss was <50 mL in all cases. Postoperatively, one patient (4.5%) had symptomatic chylous lymphocele that required surgical intervention. Precise diagnosis was established for all patients: malignant lymphoma in 20 patients and metastatic urothelial carcinoma and squamous cell carcinoma of unknown origin in 1 patient each. All lymphomas could be fully subclassified.ConclusionsAppropriate use of the transperitoneal or retroperitoneal approach is safe and effective for laparoscopic lymph node biopsy in patients with suspected intra-abdominal lymphoma.

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The effects of low-thrombin fibrin sealant on wound serous drainage, seroma formation and length of postoperative stay in patients undergoing axillary node dissection for breast cancer. A randomized controlled trial

Abstract: Low-thrombin fibrin glue reduced the amount of fluid produced in the axilla after breast surgery. Overweight patients may be the ideal candidates for this treatment. Such sealant did not increase the rates of lymphedema.

Cited by 37 publications

References 38 publications

An audit of fifty patients receiving Artiss™ fibrin sealant in lateral selective neck dissections

An audit of fifty patients receiving Artiss™ fibrin sealant in lateral selective neck dissections

Increasing the incidence of drain‐free day‐case mastectomies with the use of a fibrin tissue sealant; data from a single surgical center in the United Kingdom

Advantage of urological experience with both transperitoneal and retroperitoneal laparoscopy in lymph node biopsy for malignant lymphoma diagnosis

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