Lymph Fistulae Following Lymph Node Dissections: Avoidance and Treatment by Use of Fibrin Sealing

Waclawiczek, H. W.; Pimpl, W.

doi:10.1007/978-3-642-95513-6_23

Cited by 10 publications

(11 citation statements)

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“…Experi mental studies on pigs showed that the opti mal dosage leading to pancreatic duct occlu sion is higher than 12,000 IUk/ml of aproti nin [26], To increase the concentration of aprotinin, the easiest way is to use Trasylol (Bayer Inc., 1 ampoule = 100,000 IUk, 1 bot tle = 500,000 IUk) instead of the bottle avail able in the standard Tisseel kit (3,000 Ukl). The aprotinin concentration can thus easily be increased to 20,000 or 30,000 IUk as rec ommended by Waclawiczek and his team [ 19,21,26]. We reach the same conclusions as Gilly et al [22] and suggest the use of a glue with an increased concentration in aprotinin for lymphostasis.…”

Section: Discussionsupporting

confidence: 73%

“…Moreover, an increase of the volume of drainage fluid and of the number of complications could be doc umented in the treated group. Our results are comparable to those of Ohana et al [4] and differ from those of Waclawiczek and Pimpl [19].…”

Section: Discussionsupporting

confidence: 56%

“…In 1989, Waclawiczek and Pimpl [19] re ported the results of a prospective randomized trial. To compare the efficacy of Tisseel 500 IU on postoperative lymphorrhea after lymph node dissection, two groups of 26 patients were compared after spraying of 1 ml of Tisseel.…”

Section: Discussionmentioning

confidence: 99%

“…It was thus logical to hope that application of fibrin glue after axillary lymph node dissec tion would reduce lymphorrhea [19][20][21][22], pos sibly through its positive effects on the wound-healing process. The occurrence rate of seromas and lymphorrhea after axillary node dissections for breast cancer ranges be tween 17 and 53% in the literature [23], Even if they are not considered as major life-threat ening complications, their occurrence can lead to lymphedema and sepsis and increase the duration of the hospital stay.…”

Section: Prospective and Randomized Study In Humans Abstractmentioning

confidence: 99%

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Does Fibrin Glue Improve Drainage after Axillary Lymph Node Dissection? Prospective and Randomized Study in Humans

et al. 1995

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The aim of this prospective and randomized study was to establish whether the use of fibrin glue was beneficial after axillary lymph node dissection. From January 1990 to January 1991, 40 women were randomized before surgery for breast cancer: 20 patients (group A) underwent vaporization of fibrin glue (Tissucol®, 5 ml of 500 IU thrombin) only in the area of axillary dissection; another 20 patients (group B) served as controls. The two groups were compared for age, number of nodes removed and involved, volume and duration of fluid drainage and complications. Student’s t test, Mann-Whitney nonparametric test and the χ² test were used when appropriate for statistical analysis. The two groups were well balanced for age, number of nodes removed and involved, staging and histologic findings. The average volume of lymphorrhea in the lymph node dissection area was greater after use of fibrin glue (410.4 ml) than in controls (275.5 ml, p = 0.016). No difference was noted between the two groups for the volume of drainage fluid of the site of mastectomy or lumpectomy, or for the total volume of drainage fluid. Drainage duration as well as duration of hospital stay were similar. Six complications occurred in group A, and one in group B (p = 0.037). In contrast to our expectations, fibrin glue does not improve the postoperative period after axillary lymph node dissection; its application seems to be followed by more complications than in controls, which could be explained by the proteolytic activity of the lymph, the use of quick-acting fibrin sealant and the formation of two fibrin films in the armpit before the end of the surgical procedure.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionsupporting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Section: Prospective and Randomized Study In Humans Abstractmentioning

confidence: 99%

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Does Fibrin Glue Improve Drainage after Axillary Lymph Node Dissection? Prospective and Randomized Study in Humans

et al. 1995

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“…Aside from case reports on radiological treatment with percutaneous radiation, application of fibrin glue intra-or postoperatively and microsurgical approaches for lymphatic vessel closure were also published [11][12][13][14][15]. Medical treatment of thoracic and abdominal fistulas includes application of somatostatin analogs and total parenteral nutrition to reduce lymphatic fluid production [4,16] or the injection of radiographic contrast medium and embolization to induce adhesive closure of the fistula [17].…”

Section: Discussionmentioning

confidence: 99%

Successful doxycycline treatment of lymphatic fistulas: report of five cases and review of the literature

Hackert

Werner

Loos

et al. 2006

Langenbecks Arch Surg

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Tissue sealants for the prevention of lymphoceles after radical inguinal lymph node dissection in patients with melanoma: A systematic review and individual patient data meta‐analysis

Gerken

Dobroschke

Reißfelder

et al. 2019

Journal of Surgical Oncology

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Background and Objectives Postoperative lymphoceles and further wound complications occur frequently after radical inguinal lymph node dissection (ILND). In various studies, tissue sealants have shown to reduce the incidence of postoperative morbidity. Methods A systematic review and meta‐analysis of randomized controlled trials (RCTs) investigating the effectiveness of tissue sealants in reducing the incidence of postoperative lymphoceles following ILND in patients with melanoma was conducted. Individual patient data was requested to pool the data for meta‐analysis appropriately. Results Thousand seven hundred twenty‐nine manuscripts were screened for eligibility. Six RCTs published between 1986 and 2012 were identified including 194 patients for ILND. Only four RCTs were included in the meta‐analysis. No study properly defined the term “lymphocele.” Tissue sealants failed to influence the duration of drain placement (mean difference [MD] = −3.05 days; z = 1.18; P = 0.24), total drainage volume (MD = 598.39 mL; z = 1.49; P = 0.14), the incidence of postoperative seroma, wound infection and skin necrosis. Conclusions No improvement was identified with the use of tissue sealants, however, a valid comparison of the results of included trials was difficult owing to the lack of a definition of the term “lymphocele.” Other surgical techniques and trials using validated endpoint definitions are required to reevaluate these findings.

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Lymph Fistulae Following Lymph Node Dissections: Avoidance and Treatment by Use of Fibrin Sealing

Cited by 10 publications

References 1 publication

Does Fibrin Glue Improve Drainage after Axillary Lymph Node Dissection? Prospective and Randomized Study in Humans

Does Fibrin Glue Improve Drainage after Axillary Lymph Node Dissection? Prospective and Randomized Study in Humans

Successful doxycycline treatment of lymphatic fistulas: report of five cases and review of the literature

Tissue sealants for the prevention of lymphoceles after radical inguinal lymph node dissection in patients with melanoma: A systematic review and individual patient data meta‐analysis

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