Axillary lymphadenectomy for breast cancer in elderly patients and fibrin glue

Docimo, Giovanni; Limongelli, Paolo; Conzo, Giovanni; Gili, Simona; Bosco, Alfonso; Rizzuto, Antonia; Amoroso, Vincenzo; Marsico, Salvatore; Leone, Nicola; Esposito, Antonio; Vitiello, Chiara; Fei, Landino; Parmeggiani, Domenico; Docimo, Ludovico

doi:10.1186/1471-2482-13-s2-s8

Cited by 28 publications

(25 citation statements)

References 35 publications

(35 reference statements)

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“…In the present study, we found a signi cant decrease in the total volume of aspirated uid in the group who received brin glue compared to the control. This nding is in accordance with the results documented by other authors who used commercial brin glue in their interventions [5,[7][8][9]. However, con icting results were found by other authors, who reported inconclusive results or even harmful effects of brin glue which were explained by the presence of drains that may interfere with the maturation of the brin clot and the blockage of the lymphatic vessels [16][17][18].…”

Section: Discussionsupporting

confidence: 90%

“…Fibrin glue, light-activated brin sealant, and transdermal photopolymerized adhesive have been associated with reduction in the uid build-up post mastectomy through various studies [6][7][8][9]. Fibrin glue acts by lessening the number of disrupted lymphatics and minute vessels during axillary dissection hence resulting in lowering of seroma output [6,10] and provide hemostasis by controlling the hematomas which may delay wound healing.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Autologous Fibrin Glue on Seroma Reduction after Modified Radical Mastectomy for Breast Cancer: A Randomized Controlled Trial

Faisal

Salem

Kamel

et al. 2020

Preprint

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Introduction: Breast cancer stands out as the second most common cancer in the world with incidence 35.1% of all malignancies among females in Egypt. Fluid build-up after breast surgery is still the most annoying complication which leads to worse outcome. We aimed to evaluate whether autologous fibrin glue might lessen the formation of seroma following modified radical mastectomy. Methods: This was a randomized controlled trial designed to configure the effect of autologous fibrin glue given in the study group using the drain in comparison to a control group who received the drain only; seroma volume was calculated every 24 hrs. For all of the cases. The drains were removed when the daily drainage was less than 30 ml for 3 consecutive days. Results: We recruited 30 patients to each of the two groups. Age, pathology, breast cancer stage, number of lymph nodes and tumour size did not differ significantly between groups. A comparison of the median days to drain removal showed 8 days reduction in median days to drain removal compared in the intervention group (7 days) than the control (15 days). The patients in the fibrin glue group had a significantly lower cumulative drain output volume (mean ± SD of 505.6 ± 209.3 ml) than those in the control group (1674.1 ± 1373.8 ml). Additionally, the patients treated with fibrin glue had a significantly shorter postoperative length of stay (8.5 (7–10) days) than the controls (15 (10–23) days. Conclusions: Autologous fibrin glue significantly decrease seroma formation post-modified radical mastectomy. Research Registry Unique Identifying Number: researchregistry5372.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Effect of Autologous Fibrin Glue on Seroma Reduction after Modified Radical Mastectomy for Breast Cancer: A Randomized Controlled Trial

Faisal

Salem

Kamel

et al. 2020

Preprint

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“…Various attempts have been proposed in order to reduce seroma formation, such as external compression dressing [37], drainage placement [38][39][40][41], usage of fibrin glue [42,43], flap fixation and obliteration of the dead space [44], unfortunately with inconsistent results.…”

Section: Discussionmentioning

confidence: 99%

Advanced hemostasis in axillary lymph node dissection for locally advanced breast cancer: new technology devices compared in the prevention of seroma formation

et al. 2019

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Background: Breast cancer is the most frequent neoplasm in women. Axillary lymph nodes dissection represents the treatment of choice in locally advanced breast cancer for prognostic and curative purposes. Seroma formation, an abnormal collection of fluid in the dead space of the axilla, is described in Literature with a wide range of incidence (3-85%). It is a source of significant morbidity and discomfort. The aim of the study is to compare the different haemostasis devices used in breast surgery, investigating the eventual superiority of an instrument among the others in terms of intraoperative and postoperative outcome, especially of seroma formation. Methods: Clinical cases of female patients undergone axillary lymph nodes dissection for local advanced breast cancer between January 2013 and July 2017 at the Surgery Unit of University of Campania "Luigi Vanvitelli" were retrospectively reviewed. Patients were divided into four groups, according to device utilized during surgery: Electrocautery, Harmonic Scalpel, LigaSure and Thunderbeat. All patients underwent II level axillary lymph nodes dissection associated to radical mastectomy or quadrantectomy. Results: One hundred consecutives patients were enrolled in the study. Intra-operative blood loss resulted statistically significant different (P < 0,01) between the Electrocautery group (94,7 ml) and the Thunderbeat group (57,2 ml), while the Harmonic Scalpel group and the Ligasure group, despite presented a lower amount of blood loss, did not differ significantly. Drainage volume resulted significantly lower (P = 0,002) in the comparison between the Electrocautery group and the Thunderbeat group; the Ligasure group and Harmonic Scapel group showed no difference between them and Electrocautery group. About the seroma formation, the Electrocautery group resulted affected by the highest seroma formation rate (64%). Seroma incidence in Harmonic Scalpel group was 24%, in Ligasure group was 44%, while Thunderbeat group showed the lowest presentation of seroma with 16%. Conclusions: In patients affected by breast cancer requiring axillary lymphnodes dissection, the use of advanced hemostasis devices is highly desirable. Among the non-traditional tools, Thunderbeat resulted to be superior in terms of reduction of intra-operative blood loss and post-operative drainage output, moreover associated to a substantial reduction of postoperative seroma incidence.

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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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Axillary lymphadenectomy for breast cancer in elderly patients and fibrin glue

Cited by 28 publications

References 35 publications

Effect of Autologous Fibrin Glue on Seroma Reduction after Modified Radical Mastectomy for Breast Cancer: A Randomized Controlled Trial

Effect of Autologous Fibrin Glue on Seroma Reduction after Modified Radical Mastectomy for Breast Cancer: A Randomized Controlled Trial

Advanced hemostasis in axillary lymph node dissection for locally advanced breast cancer: new technology devices compared in the prevention of seroma formation

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

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