Randomized controlled trial of fibrin sealant to reduce postoperative drainage following elective lymph node dissection

Abstract

There was no advantage in using fibrin sealant during elective lymphadenectomy in terms of reducing drainage output or postoperative complication rate.

The use of Tisseel™ fibrin sealant in selective neck dissection – a retrospective study in a tertiary Head and Neck Surgery centre

“…Evidence in support of broad surgical application is inconclusive at present. A blinded, prospective, randomised controlled study (RCT) conducted on 74 patients undergoing elective axillary and groin lymph node dissections concluded that the use of fibrin glue to reduce drain output, duration of drainage or postoperative complications following elective axillary or inguinal lymphadenectomy cannot be justified . However, two randomised trials that investigated the use of fibrin sealant in tumour excision and axillary dissection for breast cancer in a total of 190 patients demonstrated a benefit in terms of drain output from the use of fibrin sealant .…”

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

“…The PRISMA flow chart is shown in Figure depicting the literature research results and study selection. Out of 1579 manuscripts screened for eligibility, six prospective randomized controlled trials were identified in the electronic databases meeting the eligibility criteria. Seven full‐text articles were excluded because they either did not meet inclusion criteria, the trial design was not suitable, a cointervention was performed or data was not yet published.…”

“…Two of the selected trials included patients for ILND exclusively . Four trials also examined ALND and reported the results collectively . In our study, 194 patients underwent ILND for inguinal lymph node positive malignant melanoma.…”

“…Four out of six included trials were classified as high risk of bias due to inadequate allocation consealment, selective reporting or presenting incomplete outcome data . Two studies were judged as unclear risk of bias. The risk of bias assessment of included trials is presented in Table .…”

“…Four trials evaluated the effect of sealant application during ILND on the duration of drain placement (Figure ). The trigger for the removal of drains was determined differently among the studies: either less than 50 mL or less than 30 mL over a 24‐hour period. Due to collective reporting of ALND and ILND, primary data sets of Di Monta et al and Swan et al were processed.…”