open access
Does intraoperative application of TachoSil reduce the number of lymphoceles after pelvic lymphadenectomy?
- 2nd Department of Gynecology, Medical University of Lublin, Poland
- 2nd Department of Gynecology, St' Johns Centre Oncology, Lublin, Poland
open access
Abstract
Objectives: The degree of lymphoceles prevention was assessed using collagen patches coated with human coagulation factors (TachoSil, Nycomed International Management GmbH, Zurich, Switzerland). The study enrolled 50 consecutive patients with endometrial and cervical cancer stages IB to II who had undergone open hysterectomy and pelvic lymphadenectomy (PL). In addition, the drainage volumes of 22 patients with hypertension were compared to that of the rest of the study population. Furthermore, occurrence of lymphocele in patients with endometrial and cervical cancer were compared after completion of adjuvant treatment.
Material and methods: Patients were simultaneously randomized in two groups: as a control (side without TachoSil applied) and study group (side with TachoSil applied). All surgical parameters were collected, and patients underwent ultrasound examination on postoperative days 1, 6, and 30, and at the end of treatment.
Results: The TachoSil Group showed a lower drainage volume, 30 days after surgery, while outflow of fluid occurred in 11 (22%) of all TachoSil Group cases and 22 (44%) of all control group cases. Furthermore, two patients in the control group had symptomatic lymphocele, while the same number of cases was observed in the TachoSil Group. However, the TachoSil Group demonstrated a decreased tendency to lymphocele occurrence after the end of adjuvant therapy. Here, patients with the collagen patch developed lymphocele in 12% of all cases, as opposed to 18% without TachoSil.
Conclusions: TachoSil is a useful support treatment option for reducing drainage volume and preventing lymphocele development after lymphadenectomy.
Abstract
Objectives: The degree of lymphoceles prevention was assessed using collagen patches coated with human coagulation factors (TachoSil, Nycomed International Management GmbH, Zurich, Switzerland). The study enrolled 50 consecutive patients with endometrial and cervical cancer stages IB to II who had undergone open hysterectomy and pelvic lymphadenectomy (PL). In addition, the drainage volumes of 22 patients with hypertension were compared to that of the rest of the study population. Furthermore, occurrence of lymphocele in patients with endometrial and cervical cancer were compared after completion of adjuvant treatment.
Material and methods: Patients were simultaneously randomized in two groups: as a control (side without TachoSil applied) and study group (side with TachoSil applied). All surgical parameters were collected, and patients underwent ultrasound examination on postoperative days 1, 6, and 30, and at the end of treatment.
Results: The TachoSil Group showed a lower drainage volume, 30 days after surgery, while outflow of fluid occurred in 11 (22%) of all TachoSil Group cases and 22 (44%) of all control group cases. Furthermore, two patients in the control group had symptomatic lymphocele, while the same number of cases was observed in the TachoSil Group. However, the TachoSil Group demonstrated a decreased tendency to lymphocele occurrence after the end of adjuvant therapy. Here, patients with the collagen patch developed lymphocele in 12% of all cases, as opposed to 18% without TachoSil.
Conclusions: TachoSil is a useful support treatment option for reducing drainage volume and preventing lymphocele development after lymphadenectomy.
Keywords
lymphocele; endometrial cancer; lymphadenectomy; cervical cancer; collagen patch
Title
Does intraoperative application of TachoSil reduce the number of lymphoceles after pelvic lymphadenectomy?
Journal
Issue
Article type
Research paper
Pages
278-283
Published online
2021-04-20
Page views
5343
Article views/downloads
916
DOI
Pubmed
Bibliographic record
Ginekol Pol 2022;93(4):278-283.
Keywords
lymphocele
endometrial cancer
lymphadenectomy
cervical cancer
collagen patch
Authors
Andrzej Wrobel
Izabela Winkler
Tomasz Rechberger
Katarzyna Skorupska
Pawel Miotla
- Tinelli A, Mynbaev OA, Tsin DA, et al. Lymphocele prevention after pelvic laparoscopic lymphadenectomy by a collagen patch coated with human coagulation factors: a matched case-control study. Int J Gynecol Cancer. 2013; 23(5): 956–963.
- Frost JA, Webster KE, Bryant A, et al. Lymphadenectomy for the management of endometrial cancer. Cochrane Database Syst Rev. 2015(9): CD007585.
- Achouri A, Huchon C, Bats AS, et al. Postoperative lymphocysts after lymphadenectomy for gynaecological malignancies: preventive techniques and prospects. Eur J Obstet Gynecol Reprod Biol. 2012; 161(2): 125–129.
- Buda A, Ghelardi A, Fruscio R, et al. The contribution of a collagen-fibrin patch (Tachosil) to prevent the postoperative lymphatic complications after groin lymphadenectomy: a double institution observational study. Eur J Obstet Gynecol Reprod Biol. 2016; 197: 156–158.
- Grimm C, Polterauer S, Helmy-Bader S, et al. A collagen-fibrin patch (Tachosil®) for the prevention of symptomatic lymphoceles after pelvic lymphadenectomy in women with gynecologic malignancies: a randomized clinical trial. BMC Cancer. 2014; 14(1): 635–145.
- Minig L, Patrono MG, Cárdenas-Rebollo JM, et al. Use of TachoSil® to Prevent Symptomatic Lymphocele after an Aggressive Tumor Debulking with Lymphadenectomy for Advanced Stage Ovarian Cancer. A Pilot Study. Gynecol Obstet Invest. 2016; 81(6): 497–503.
- Spotnitz WD, Burks S. Hemostats, sealants, and adhesives: components of the surgical toolbox. Transfusion. 2008; 48(7): 1502–1516.
- Erdogan D, de Graaf W, van Gulik TM. Adhesive strength of fibrinogen-coated collagen patch or liquid fibrin sealant in an experimental liver resection model in pigs. Eur Surg Res. 2008; 41(3): 298–302.
- Song SY, Park M, Kang BH, et al. Distribution of lymphocele following lymphadenectomy in patients with gynecological malignancies. Obstet Gynecol Sci. 2020; 63(6): 700–708.
- Xu H, Chen Y, Li Y, et al. Complications of laparoscopic radical hysterectomy and lymphadenectomy for invasive cervical cancer: experience based on 317 procedures. Surg Endosc. 2007; 21(6): 960–964.
- Tinelli A, Giorda G, Manca C, et al. Prevention of lymphocele in female pelvic lymphadenectomy by a collagen patch coated with the human coagulation factors: a pilot study. J Surg Oncol. 2012; 105(8): 835–840.
- Radosa MP, Diebolder H, Camara O, et al. Laparoscopic lymphocele fenestration in gynaecological cancer patients after retroperitoneal lymph node dissection as a first-line treatment option. BJOG. 2013; 120(5): 628–636.
- Simonato A, Varca V, Esposito M, et al. The use of a surgical patch in the prevention of lymphoceles after extraperitoneal pelvic lymphadenectomy for prostate cancer: a randomized prospective pilot study. J Urol. 2009; 182(5): 2285–2290.
- Achouri A, Huchon C, Bats AS, et al. Complications of lymphadenectomy for gynecologic cancer. Eur J Surg Oncol. 2013; 39(1): 81–86.