Fibrin sealant does not decrease seroma output or time to drain removal following inguino-femoral lymph node dissection in melanoma patients: A randomized controlled trial (NCT00506311)
Identifieur interne : 006B13 ( Main/Exploration ); précédent : 006B12; suivant : 006B14Fibrin sealant does not decrease seroma output or time to drain removal following inguino-femoral lymph node dissection in melanoma patients: A randomized controlled trial (NCT00506311)
Auteurs : Melinda M. Mortenson [États-Unis] ; Yan Xing [États-Unis] ; Storm Weaver [États-Unis] ; Jeffrey E. Lee [États-Unis] ; Jeffrey E. Gershenwald [États-Unis] ; Anthony Lucci [États-Unis] ; Paul F. Mansfield [États-Unis] ; Merrick I. Ross [États-Unis] ; Janice N. Cormier [États-Unis]Source :
- World Journal of Surgical Oncology [ 1477-7819 ] ; 2008.
Abstract
This study assessed the impact of closed suction drains and evaluated whether the intraoperative use of a fibrin sealant decreased time to drain removal and wound complications in melanoma patients undergoing inguino-femoral lymph node dissection.
A pilot study (n = 18) assessed the impact of a closed suction drain following inguino-femoral lymph node dissection. A single-institution, prospective trial was then performed in which patients were randomized to a group that received intraoperative application of a fibrin sealant following inguino-femoral lymph node dissection or to a control group that did not receive sealant.
The majority of the patients enrolled felt the drains caused moderate or severe discomfort and difficulties with activities of daily living. Thirty patients were then randomized; the median time to drain removal in the control group (n = 14) was 30 days (range, 13–74) compared to 29 days (range, 11–45) in the fibrin sealant group (n = 16;
Postoperative closed suction drains were associated with major patient inconvenience. Applying a fibrin sealant at the time of inguino-femoral lymph node dissection in melanoma patients did not reduce the time to drain removal or postoperative morbidity. Alternative strategies are needed.
Url:
DOI: 10.1186/1477-7819-6-63
PubMed: 18564433
PubMed Central: 2464595
Affiliations:
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Anderson Cancer Center, Houston, Texas, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas</wicri:regionArea><placeName><region type="state">Texas</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="I2">Associate Professor of Surgery and Biostatistics, Department of Surgical Oncology-Unit 444, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030-1402, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Associate Professor of Surgery and Biostatistics, Department of Surgical Oncology-Unit 444, The University of Texas M. D. 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Mortenson</name><affiliation wicri:level="2"><nlm:aff id="I1">Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas</wicri:regionArea><placeName><region type="state">Texas</region></placeName></affiliation></author><author><name sortKey="Xing, Yan" sort="Xing, Yan" uniqKey="Xing Y" first="Yan" last="Xing">Yan Xing</name><affiliation wicri:level="2"><nlm:aff id="I1">Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas</wicri:regionArea><placeName><region type="state">Texas</region></placeName></affiliation></author><author><name sortKey="Weaver, Storm" sort="Weaver, Storm" uniqKey="Weaver S" first="Storm" last="Weaver">Storm Weaver</name><affiliation wicri:level="2"><nlm:aff id="I1">Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas</wicri:regionArea><placeName><region type="state">Texas</region></placeName></affiliation></author><author><name sortKey="Lee, Jeffrey E" sort="Lee, Jeffrey E" uniqKey="Lee J" first="Jeffrey E" last="Lee">Jeffrey E. Lee</name><affiliation wicri:level="2"><nlm:aff id="I1">Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas</wicri:regionArea><placeName><region type="state">Texas</region></placeName></affiliation></author><author><name sortKey="Gershenwald, Jeffrey E" sort="Gershenwald, Jeffrey E" uniqKey="Gershenwald J" first="Jeffrey E" last="Gershenwald">Jeffrey E. Gershenwald</name><affiliation wicri:level="2"><nlm:aff id="I1">Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas</wicri:regionArea><placeName><region type="state">Texas</region></placeName></affiliation></author><author><name sortKey="Lucci, Anthony" sort="Lucci, Anthony" uniqKey="Lucci A" first="Anthony" last="Lucci">Anthony Lucci</name><affiliation wicri:level="2"><nlm:aff id="I1">Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas</wicri:regionArea><placeName><region type="state">Texas</region></placeName></affiliation></author><author><name sortKey="Mansfield, Paul F" sort="Mansfield, Paul F" uniqKey="Mansfield P" first="Paul F" last="Mansfield">Paul F. Mansfield</name><affiliation wicri:level="2"><nlm:aff id="I1">Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas</wicri:regionArea><placeName><region type="state">Texas</region></placeName></affiliation></author><author><name sortKey="Ross, Merrick I" sort="Ross, Merrick I" uniqKey="Ross M" first="Merrick I" last="Ross">Merrick I. Ross</name><affiliation wicri:level="2"><nlm:aff id="I1">Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas</wicri:regionArea><placeName><region type="state">Texas</region></placeName></affiliation></author><author><name sortKey="Cormier, Janice N" sort="Cormier, Janice N" uniqKey="Cormier J" first="Janice N" last="Cormier">Janice N. Cormier</name><affiliation wicri:level="2"><nlm:aff id="I1">Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas</wicri:regionArea><placeName><region type="state">Texas</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="I2">Associate Professor of Surgery and Biostatistics, Department of Surgical Oncology-Unit 444, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030-1402, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Associate Professor of Surgery and Biostatistics, Department of Surgical Oncology-Unit 444, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030-1402</wicri:regionArea><wicri:noRegion>TX 77030-1402</wicri:noRegion></affiliation></author></analytic><series><title level="j">World Journal of Surgical Oncology</title><idno type="eISSN">1477-7819</idno><imprint><date when="2008">2008</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>This study assessed the impact of closed suction drains and evaluated whether the intraoperative use of a fibrin sealant decreased time to drain removal and wound complications in melanoma patients undergoing inguino-femoral lymph node dissection.</p></sec><sec sec-type="methods"><title>Methods</title><p>A pilot study (n = 18) assessed the impact of a closed suction drain following inguino-femoral lymph node dissection. A single-institution, prospective trial was then performed in which patients were randomized to a group that received intraoperative application of a fibrin sealant following inguino-femoral lymph node dissection or to a control group that did not receive sealant.</p></sec><sec><title>Results</title><p>The majority of the patients enrolled felt the drains caused moderate or severe discomfort and difficulties with activities of daily living. Thirty patients were then randomized; the median time to drain removal in the control group (n = 14) was 30 days (range, 13–74) compared to 29 days (range, 11–45) in the fibrin sealant group (n = 16; <italic>P </italic>= 0.6). Major and minor complications were similar in the two groups.</p></sec><sec><title>Conclusion</title><p>Postoperative closed suction drains were associated with major patient inconvenience. Applying a fibrin sealant at the time of inguino-femoral lymph node dissection in melanoma patients did not reduce the time to drain removal or postoperative morbidity. Alternative strategies are needed.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Texas</li></region></list><tree><country name="États-Unis"><region name="Texas"><name sortKey="Mortenson, Melinda M" sort="Mortenson, Melinda M" uniqKey="Mortenson M" first="Melinda M" last="Mortenson">Melinda M. Mortenson</name></region><name sortKey="Cormier, Janice N" sort="Cormier, Janice N" uniqKey="Cormier J" first="Janice N" last="Cormier">Janice N. Cormier</name><name sortKey="Cormier, Janice N" sort="Cormier, Janice N" uniqKey="Cormier J" first="Janice N" last="Cormier">Janice N. Cormier</name><name sortKey="Gershenwald, Jeffrey E" sort="Gershenwald, Jeffrey E" uniqKey="Gershenwald J" first="Jeffrey E" last="Gershenwald">Jeffrey E. Gershenwald</name><name sortKey="Lee, Jeffrey E" sort="Lee, Jeffrey E" uniqKey="Lee J" first="Jeffrey E" last="Lee">Jeffrey E. Lee</name><name sortKey="Lucci, Anthony" sort="Lucci, Anthony" uniqKey="Lucci A" first="Anthony" last="Lucci">Anthony Lucci</name><name sortKey="Mansfield, Paul F" sort="Mansfield, Paul F" uniqKey="Mansfield P" first="Paul F" last="Mansfield">Paul F. Mansfield</name><name sortKey="Ross, Merrick I" sort="Ross, Merrick I" uniqKey="Ross M" first="Merrick I" last="Ross">Merrick I. Ross</name><name sortKey="Weaver, Storm" sort="Weaver, Storm" uniqKey="Weaver S" first="Storm" last="Weaver">Storm Weaver</name><name sortKey="Xing, Yan" sort="Xing, Yan" uniqKey="Xing Y" first="Yan" last="Xing">Yan Xing</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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