title: Synthetic cyanoacrylic glue in the prevention of post-operative lymphocele after pelvic lymphadenectomy in patients with uterine malignancies: A prospective, single-blind, preliminary study.
abstract: OBJECTIVE
  Lymphoceles are among the most common post-operative complications of pelvic lymphadenectomy, with a reported incidence of 1% to 29% in gynecology oncology. Several studies evaluated the effectiveness of biological glues on reducing lymphoceles, but no data on gynecological patients are available. We evaluated the effectiveness of cyanoacrylic glues (n-butyl cyanoacrylate) (Glubran 2 - GEM s.r.l., Italy) in preventing lymphocele on 30 patients who underwent pelvic lymphadenectomy for endometrial or cervical cancer.
  
  
  METHODS
  Single-blind prospective randomized study. Patients were divided into 2 groups: pelvic lymphadenectomy plus n-butyl cyanoacrylate (treatment group: 44 patients) and pelvic lymphadenectomy without n-butyl cyanoacrylate (control group: 44 patients). Primary endpoint was incidence of pelvic lymphocele in the two groups 30 days after surgery, and evaluated with pelvic ultrasound and RMI examination. Secondary endpoints evaluated drainage volume of lymphorrhea 36, 48, 72 and 96 h after surgery.
  
  
  RESULTS
  15% in the treatment group and 36.6% in the control group had lymphocele 1month after the procedure (p<0.03; RR 0.4 [95% CI 0.152-0.999]). Concerning the secondary outcome in group A the amount of lymphorrhea presented a constant significant decrease during evaluation; on the contrary, in group B, after an initial decrease at 48 h, the amount of lymphorrhea remained unchanged; at all considered times the amount of lymphorrhea resulted significantly greater in controls.
  
  
  CONCLUSIONS
  Intraoperative application of n-butyl cyanoacrylate seems to reduce lymph production after pelvic lymphadenectomy, providing a useful additional treatment option for reducing drainage volume and preventing lymphocele development after pelvic lymphadenectomy.
authors: Department of Gynaecology and Obstetrics, and Pathophysiology of Human Reproduction, University of Naples "Federico II", Via Pansini 5, 80131 Naples, Italy.
authors: G
authors: G
authors: Bifulco
authors: Department of Gynaecology and Obstetrics, and Pathophysiology of Human Reproduction, University of Naples "Federico II", Via Pansini 5, 80131 Naples, Italy. Electronic address: giam.piggi@virgilio.it.
authors: P
authors: P
authors: Giampaolino
authors: Department of Gynaecology and Obstetrics, and Pathophysiology of Human Reproduction, University of Naples "Federico II", Via Pansini 5, 80131 Naples, Italy.
authors: I
authors: I
authors: Morra
authors: Department of Gynaecology and Obstetrics, and Pathophysiology of Human Reproduction, University of Naples "Federico II", Via Pansini 5, 80131 Naples, Italy.
authors: G A
authors: GA
authors: Tommaselli
authors: Department of Gynaecology and Obstetrics, and Pathophysiology of Human Reproduction, University of Naples "Federico II", Via Pansini 5, 80131 Naples, Italy.
authors: F
authors: F
authors: Tarsitano
authors: Department of Gynaecology and Obstetrics, and Pathophysiology of Human Reproduction, University of Naples "Federico II", Via Pansini 5, 80131 Naples, Italy.
authors: G
authors: G
authors: Chiacchio
authors: Department of Gynaecology and Obstetrics, and Pathophysiology of Human Reproduction, University of Naples "Federico II", Via Pansini 5, 80131 Naples, Italy.
authors: C
authors: C
authors: Nappi
authors: Department of Gynaecology and Obstetrics, and Pathophysiology of Human Reproduction, University of Naples "Federico II", Via Pansini 5, 80131 Naples, Italy.
authors: C
authors: C
authors: Di Carlo
mesh_terms: D000269:Adhesives; D003487:Cyanoacrylates; D005260:Female; D006801:Humans; D015994:Incidence; D008197:Lymph Node Excision / Q000009:adverse effects*; D008210:Lymphocele / Q000453:epidemiology / Q000517:prevention & control*; D008875:Middle Aged; D010388:Pelvis; D011446:Prospective Studies; D016037:Single-Blind Method; D014594:Uterine Neoplasms / Q000601:surgery*
chemical_list: D000269:Adhesives; D003487:Cyanoacrylates
keywords: Cyanoacrylate glue; Lymphocele; Lymphorrea; Pelvic lymphadenectomy; Post-operative complications; Uterine malignancies