title: Prevention of lymphocele in female pelvic lymphadenectomy by a collagen patch coated with the human coagulation factors: a pilot study.
abstract: OBJECTIVE
  The prevention of lymphoceles was tested using collagen patch coated with the human coagulation factors (TachoSil) on 58 consecutive patients with endometrial cancer who had undergone hysterectomy and pelvic lymphadenectomy (PL).
  
  
  METHODS
  Patients were randomized in two groups: standard technique plus TachoSil (30 patients, group 1) and standard technique only (28, group 2). All surgical parameters were collected and patients underwent ultrasound examination on postoperative days 7, 14, and 28. The main outcome measures were: the development of symptomatic or asymptomatic lymphoceles, the need for further surgical intervention, as adverse effect of surgery and the drainage volume and duration.
  
  
  RESULTS
  Same number of lymph nodes in both groups was removed; group 1 showed a lower drainage volume. Lymphoceles developed in 7 patients in group 1 and 16 in group 2, but only 3 were symptomatic in group 1 and 9 symptomatic in group 2, with statistical difference. Percutaneous drainage proved necessary in five cases: only one was in group 1 and four in group 2.
  
  
  CONCLUSIONS
  Intraoperative application of TachoSil reduced rate of postoperative lymphocysts after PL, and it seems to provide a useful additional treatment option for reducing drainage volume and preventing lymphocele development after PL.
authors: Division of Experimental Endoscopic Surgery, Imaging, Minimally Invasive Therapy & Technology, Department of Obstetrics and Gynaecology, Vito Fazzi Hospital, Lecce, Italy. andreatinelli@gmail.com
authors: Andrea
authors: A
authors: Tinelli
authors: Giorgio
authors: G
authors: Giorda
authors: Corrado
authors: C
authors: Manca
authors: Marcello
authors: M
authors: Pellegrino
authors: Raffaele
authors: R
authors: Prudenzano
authors: Marcello
authors: M
authors: Guido
authors: Domenico
authors: D
authors: Dell'Edera
authors: Antonio
authors: A
authors: Malvasi
mesh_terms: D001779:Blood Coagulation Factors / Q000378:metabolism; D003094:Collagen / Q000378:metabolism*; D004338:Drug Combinations; D016889:Endometrial Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D005340:Fibrinogen / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D008197:Lymph Node Excision / Q000009:adverse effects*; D008210:Lymphocele / Q000209:etiology / Q000517:prevention & control*; D008875:Middle Aged; D009367:Neoplasm Staging; D010388:Pelvis / Q000601:surgery*; D010865:Pilot Projects; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D015503:Surgical Sponges; D013917:Thrombin / Q000627:therapeutic use*
chemical_list: D001779:Blood Coagulation Factors; D004338:Drug Combinations; C518955:TachoSil; D005340:Fibrinogen; D003094:Collagen; D013917:Thrombin