A prospective randomized trial: The influence of intraoperative application of fibrin glue after radical inguinal/iliacal lymph node dissection on postoperative morbidity

Neuß, H.; Raue, W.; Koplin, Gerold; Schwenk, W.; Reetz, Christian; Mall, Julian W.

doi:10.1016/j.ejso.2008.09.016

Cited by 37 publications

(27 citation statements)

References 27 publications

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“…In addition, along with the decrease in postoperative vaginal bleeding, there was considerable improvement in the disability in everyday life (tables 2, 3). The results of the present study are consistent with those of earlier studies which reported that fibrin sealant has significant hemostatic effects in various surgical fields [12,13,14,15,16]. Furthermore, this study was the first prospective randomized study to demonstrate the potential hemostatic effects of fibrin sealant in LEEP for CIN 2 or 3.…”

Section: Discussionsupporting

confidence: 82%

A Pilot Study to Investigate the Efficacy of Fibrin Sealant (Tisseel®) in the Loop Electrosurgical Excision Procedure

Kim

Park

et al. 2015

Gynecol Obstet Invest

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Aims: The objective of the current study was to evaluate the efficacy and feasibility of fibrin sealant (Tisseel®) in the loop electrosurgical excision procedure (LEEP) for cervical intraepithelial neoplasia (CIN 2 or 3). Methods: We designed a single-blind, prospective, randomized study in 40 consecutive women undergoing LEEP for CIN 2 or 3 at our institute. Two milliliters of fibrin sealant (Tisseel) was applied to the uterine cervix of 20 women immediately after LEEP surgery (treatment group). We evaluated abdominal pain, vaginal bleeding, vaginal discharge and impairment in daily living after 1 week using visual analogue scale questionnaires and compared the results with those of 20 women who did not receive fibrin sealant (control group). Results: Among 40 women who returned for a follow-up 1 week after LEEP, 25 women (62.5%) reported at least one moderate to severe postprocedural symptom. The mean duration of moderate to severe vaginal bleeding and impairment in daily living during postoperative week 1 for the treatment group and the control group was 0.3 ± 0.80 versus 1.7 ± 2.36 days (p = 0.015) and 0.9 ± 1.37 versus 3.00 ± 2.62 days (p = 0.060), respectively. Conclusion: Intraoperative application of fibrin sealant (Tisseel) in LEEP can decrease postoperative vaginal bleeding and impairment in daily living.

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Section: Discussionsupporting

confidence: 82%

A Pilot Study to Investigate the Efficacy of Fibrin Sealant (Tisseel®) in the Loop Electrosurgical Excision Procedure

Kim

Park

et al. 2015

Gynecol Obstet Invest

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“…All patients with a therapeutic indication underwent the RILND by an experienced surgeon (JWM) carried out in an identical fashion as described before (2).…”

Section: Peri-operative Treatment and Datamentioning

confidence: 99%

“…A melanoma positive sentinel node of the inguinal region, representing the first regional lymph node basin of the lower extremity, is the classical indication for the radical LND in patients with a primary melanoma. The sentinel lymph node biopsy (SLNB) or fine needle aspiration cytology (FNAC) provides a selective surgical approach (1,2). The standard procedure in the surgical department of the Charité Campus Mitte in co-operation with the department of Dermatology and Allergology (Head : Professor W. Sterry, MD -Medical Faculty of the Humboldt University, Berlin -Charité) is the combined radical inguinal/iliacal LND (RILND) after a positive SLNB or FNAC of the groin (2)(3)(4)(5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

Influence of Surgical Complications on the Level of Pain after Radical Inguinal/Iliacal Lymph Node Dissection

Neuß

Reetz

Raue

et al. 2010

Acta Chirurgica Belgica

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“…The commonest reason behind the lengthy hospital stay following lymphadenectomy is usually an attempt to prevent or reduce seroma formation by delaying the removal of drains. Various techniques have been devised to reduce the rate of seroma formation, including the use of suction drains [15], quilting techniques [16], the use of erythromycin sclerotherapy [17], fibrin glue application [18] and the use of external compression [19]; none of these strategies has resolved the issue of seroma formation. Nonetheless, patients treated with volume-controlled drainage were less likely to develop clinically significant seromas than in patients treated with no drains or early removal of drains [20].…”

Section: Discussionmentioning

confidence: 99%

Introducing an enhanced recovery after surgery (ERAS) pathway for regional lymph node dissection: clinical and financial implications

2015

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Background Enhanced recovery after surgery (ERAS) protocols aim to improve patient care, reduce complication rates and shorten hospital stay following surgery. The key elements of these protocols include preoperative counselling, standardized analgesia and early mobilization. We present our experience in applying ERAS pathway for skin cancer patients requiring regional lymph node dissection (LND). Our protocol streamlines from the initial clinic consultation and perioperative management to safe discharge and regular clinic follow-up. Methods Prospective data collection of 100 consecutive patients who underwent LND, performed by the senior author, was done. Data included patient demographics, initial diagnosis, initial clinic appointment, surgery date, discharge date, number of follow-up clinics and complications. Our results were compared to the results of an audit of 50 consecutive patients managed in our department prior to the introduction of the presented protocol. ResultsOur ERAS pathway resulted in a shorter hospital stay and fewer complication rates. Our patients were discharged, with drains in situ. Our mean length of stay (LOS) for axillary, inguinal and neck LND was 1.18, 2 and 4.1 days, respectively. The overall LOS was 2.4 versus 9.5 days in the audited previous practice. Our complication rate was 50 % less (P= 0.002). This also resulted in substantial financial savings. Conclusions ERAS protocol for skin cancer patients requiring LND is based on multi-disciplinary team (MDT) approach. It has proven to be an efficient and safe streamlined pathway from consultation to discharge, with shorter hospital stay and satisfactory clinical outcomes as well as substantial financial savings that could be recruited in other services. Level of Evidence: Level III, risk/prognostic study.

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A prospective randomized trial: The influence of intraoperative application of fibrin glue after radical inguinal/iliacal lymph node dissection on postoperative morbidity

Cited by 37 publications

References 27 publications

A Pilot Study to Investigate the Efficacy of Fibrin Sealant (Tisseel®) in the Loop Electrosurgical Excision Procedure

A Pilot Study to Investigate the Efficacy of Fibrin Sealant (Tisseel®) in the Loop Electrosurgical Excision Procedure

Influence of Surgical Complications on the Level of Pain after Radical Inguinal/Iliacal Lymph Node Dissection

Introducing an enhanced recovery after surgery (ERAS) pathway for regional lymph node dissection: clinical and financial implications

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