title: The Use of Haemostatic Agents and Sealants for the Prevention of Lymphocele After Urological Surgery: A Review of the Literature.
abstract: BACKGROUND
  Despite the continuous technological innovation in urological surgery procedures, lymphocele represents one of the major and more frequent complications both in tumour and transplant surgery. Haemostatic agents have been used hypothesizing a beneficial effect on the prevention of lymphoceles. We aimed to review the published literature to establish whether haemostatic agents and sealants are an effective option for lymphocele prevention following urological procedure.
  
  
  METHODS
  An extensive PubMed search was performed including the following keywords: "lymphocele", "lymphocele prevention", "fibrin glue", "collagen patch", "fibrin patch", and "haemostatic material". The search, which collected data until January 2000, was restricted to the full text available articles in the English language and human studies.
  
  
  RESULTS
  Our research identified 64 articles, among these only four fulfilled the inclusion criteria. A total of 133 patients underwent surgery and were treated with haemostatic agents and/or sealants to reduce the lymphoceles formation. The mean age was 56.1 years. A negligible variability in study design and in results and complication reporting is common. The 6.45% of patients treated with haemostatic biomaterials developed lymphocele. The rate difference of lymphoceles formation and recurrence between patient groups treated with sealant than in the controls groups is small (6.45% vs 6.88%).
  
  
  CONCLUSIONS
  The evidences presented in the examined studies are only preliminary and insufficient to draw significant conclusions. A major, multicentre, randomized controlled trial is strongly needed.
authors.affiliation: Biomedical Science, Università degli Studi "G.D'Annunzio", Chieti-Pescara, Chieti, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Marchioni
authors.affiliation: Biomedical Science, Università degli Studi "G.D'Annunzio", Chieti-Pescara, Chieti, Italy.
authors.forename: Manuela
authors.initials: M
authors.lastname: Ingrosso
authors.affiliation: Biomedical Science, Università degli Studi "G.D'Annunzio", Chieti-Pescara, Chieti, Italy.
authors.forename: Piergustavo
authors.initials: P
authors.lastname: De Francesco
authors.affiliation: Biomedical Science, Università degli Studi "G.D'Annunzio", Chieti-Pescara, Chieti, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Primiceri
authors.affiliation: Biomedical Science, Università degli Studi "G.D'Annunzio", Chieti-Pescara, Chieti, Italy.
authors.forename: Rossella
authors.initials: R
authors.lastname: Manco
authors.affiliation: Biomedical Science, Università degli Studi "G.D'Annunzio", Chieti-Pescara, Chieti, Italy.
authors.forename: Raffaele Lanfranco
authors.initials: RL
authors.lastname: Tenaglia
mesh_terms: D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D008210:Lymphocele / Q000453:epidemiology / Q000517:prevention & control*; D008875:Middle Aged; D014014:Tissue Adhesives / Q000627:therapeutic use*; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data
chemical_list: D006490:Hemostatics; D014014:Tissue Adhesives