Prevention of lymphocele by using gelatin-thrombin matrix as a tissue sealant after pelvic lymphadenectomy in patients with gynecologic cancers: a prospective randomized controlled study
Identifieur interne : 004075 ( Pmc/Curation ); précédent : 004074; suivant : 004076Prevention of lymphocele by using gelatin-thrombin matrix as a tissue sealant after pelvic lymphadenectomy in patients with gynecologic cancers: a prospective randomized controlled study
Auteurs : Yun Hwan Kim ; Hyun Joo Shin ; Woong Ju ; Seung-Cheol KimSource :
- Journal of Gynecologic Oncology [ 2005-0380 ] ; 2017.
Abstract
This prospective randomized controlled pilot study aimed to find whether gelatin-thrombin matrix used as a tissue sealant (FloSeal) can prevent the occurrence of pelvic lymphocele in patients with gynecologic cancer who has undergone pelvic lymphadenectomy.
Each patient, who undergo a laparotomic pelvic lymph node dissection on both sides, was randomly assigned for FloSeal application on 1 side of the pelvis. The other side of the pelvis without any product application being the control side. The amount of lymph drainage at each side of the pelvis was measured for 3 days, and computed tomography scans were obtained 7 days and 6 months after surgery for detection of pelvic lymphocele.
Among 37 cases, the median amount of lymph drainage was significantly decreased in the hemi-pelvis treated with FloSeal compared to the control hemi-pelvis (p=0.025). The occurrence of lymphocele was considerably reduced in treated hemi-pelvis (8/37, 21.6%) compared with control hemi-pelvis (12/37, 32.4%) after 7 post-operative days (p=0.219), and more decreased in the treated hemi-pelvis (5/37, 13.5%) compared with control hemi-pelvis (9/37, 24.3%) after postoperative 6 months (p=0.344).
The application of FloSeal as a tissue sealant in lymph nodes resected tissues can reduce the incidence of pelvic lymphocele in gynecologic cancer patients. A large randomized controlled study could confirm these preliminary results.
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DOI: 10.3802/jgo.2017.28.e37
PubMed: 28382800
PubMed Central: 5391396
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The other side of the pelvis without any product application being the control side. The amount of lymph drainage at each side of the pelvis was measured for 3 days, and computed tomography scans were obtained 7 days and 6 months after surgery for detection of pelvic lymphocele.</p></sec><sec><title>Results</title><p>Among 37 cases, the median amount of lymph drainage was significantly decreased in the hemi-pelvis treated with FloSeal compared to the control hemi-pelvis (p=0.025). The occurrence of lymphocele was considerably reduced in treated hemi-pelvis (8/37, 21.6%) compared with control hemi-pelvis (12/37, 32.4%) after 7 post-operative days (p=0.219), and more decreased in the treated hemi-pelvis (5/37, 13.5%) compared with control hemi-pelvis (9/37, 24.3%) after postoperative 6 months (p=0.344).</p></sec><sec><title>Conclusion</title><p>The application of FloSeal as a tissue sealant in lymph nodes resected tissues can reduce the incidence of pelvic lymphocele in gynecologic cancer patients. A large randomized controlled study could confirm these preliminary results.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Selman, Tj" uniqKey="Selman T">TJ Selman</name></author><author><name sortKey="Mann, C" uniqKey="Mann C">C Mann</name></author><author><name sortKey="Zamora, J" uniqKey="Zamora J">J Zamora</name></author><author><name sortKey="Appleyard, Tl" uniqKey="Appleyard T">TL Appleyard</name></author><author><name sortKey="Khan, K" uniqKey="Khan K">K Khan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Selman, Tj" uniqKey="Selman T">TJ Selman</name></author><author><name sortKey="Mann, Ch" uniqKey="Mann C">CH Mann</name></author><author><name sortKey="Zamora, J" uniqKey="Zamora J">J Zamora</name></author><author><name sortKey="Khan, Ks" uniqKey="Khan K">KS Khan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Petru, E" uniqKey="Petru E">E 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<front><journal-meta><journal-id journal-id-type="nlm-ta">J Gynecol Oncol</journal-id><journal-id journal-id-type="iso-abbrev">J Gynecol Oncol</journal-id><journal-id journal-id-type="publisher-id">JGO</journal-id><journal-title-group><journal-title>Journal of Gynecologic Oncology</journal-title></journal-title-group><issn pub-type="ppub">2005-0380</issn><issn pub-type="epub">2005-0399</issn><publisher><publisher-name>Asian Society of Gynecologic Oncology; Korean Society of Gynecologic Oncology</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">28382800</article-id><article-id pub-id-type="pmc">5391396</article-id><article-id pub-id-type="doi">10.3802/jgo.2017.28.e37</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject><subj-group subj-group-type="subheading"><subject>Surgery</subject></subj-group></subj-group></article-categories><title-group><article-title>Prevention of lymphocele by using gelatin-thrombin matrix as a tissue sealant after pelvic lymphadenectomy in patients with gynecologic cancers: a prospective randomized controlled study</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid" authenticated="true">http://orcid.org/0000-0001-9498-2938</contrib-id><name><surname>Kim</surname><given-names>Yun Hwan</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="true">http://orcid.org/0000-0002-5359-9251</contrib-id><name><surname>Shin</surname><given-names>Hyun Joo</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="true">http://orcid.org/0000-0002-0013-8304</contrib-id><name><surname>Ju</surname><given-names>Woong</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="true">http://orcid.org/0000-0002-5000-9914</contrib-id><name><surname>Kim</surname><given-names>Seung-Cheol</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib></contrib-group><aff id="A1">Department of Obstetrics and Gynecology, Ewha Womans University School of Medicine, Seoul,<country>Korea</country>.</aff><author-notes><corresp>Correspondence to Yun Hwan Kim. Department of Obstetrics and Gynecology, Ewha Womans University School of Medicine, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 07985, Korea. <email>kimyhmd@ewha.ac.kr</email></corresp></author-notes><pub-date pub-type="ppub"><month>5</month><year>2017</year></pub-date><pub-date pub-type="epub"><day>28</day><month>2</month><year>2017</year></pub-date><volume>28</volume><issue>3</issue><elocation-id>e37</elocation-id><history><date date-type="received"><day>12</day><month>11</month><year>2016</year></date><date date-type="rev-recd"><day>22</day><month>1</month><year>2017</year></date><date date-type="accepted"><day>08</day><month>2</month><year>2017</year></date></history><permissions><copyright-statement>Copyright © 2017. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology</copyright-statement><copyright-year>2017</copyright-year><license license-type="open-access" xlink:href="https://creativecommons.org/licenses/by-nc/4.0/"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (<ext-link ext-link-type="uri" xlink:href="https://creativecommons.org/licenses/by-nc/4.0/">https://creativecommons.org/licenses/by-nc/4.0/</ext-link>) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><sec><title>Objective</title><p>This prospective randomized controlled pilot study aimed to find whether gelatin-thrombin matrix used as a tissue sealant (FloSeal) can prevent the occurrence of pelvic lymphocele in patients with gynecologic cancer who has undergone pelvic lymphadenectomy.</p></sec><sec><title>Methods</title><p>Each patient, who undergo a laparotomic pelvic lymph node dissection on both sides, was randomly assigned for FloSeal application on 1 side of the pelvis. The other side of the pelvis without any product application being the control side. The amount of lymph drainage at each side of the pelvis was measured for 3 days, and computed tomography scans were obtained 7 days and 6 months after surgery for detection of pelvic lymphocele.</p></sec><sec><title>Results</title><p>Among 37 cases, the median amount of lymph drainage was significantly decreased in the hemi-pelvis treated with FloSeal compared to the control hemi-pelvis (p=0.025). The occurrence of lymphocele was considerably reduced in treated hemi-pelvis (8/37, 21.6%) compared with control hemi-pelvis (12/37, 32.4%) after 7 post-operative days (p=0.219), and more decreased in the treated hemi-pelvis (5/37, 13.5%) compared with control hemi-pelvis (9/37, 24.3%) after postoperative 6 months (p=0.344).</p></sec><sec><title>Conclusion</title><p>The application of FloSeal as a tissue sealant in lymph nodes resected tissues can reduce the incidence of pelvic lymphocele in gynecologic cancer patients. A large randomized controlled study could confirm these preliminary results.</p></sec></abstract><kwd-group kwd-group-type="author"><kwd>Genital Neoplasms, Female</kwd><kwd>Lymphocele</kwd><kwd>Drainage</kwd><kwd>Secondary Prevention</kwd><kwd>Lymph Node Excision</kwd><kwd>Surgical Oncology</kwd></kwd-group><funding-group><award-group><funding-source country="KR"><institution-wrap><institution>Ewha Womans University</institution><institution-id institution-id-type="CrossRef">http://dx.doi.org/10.13039/501100002630</institution-id></institution-wrap></funding-source></award-group></funding-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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