title: The contribution of a collagen-fibrin patch (Tachosil) to prevent the postoperative lymphatic complications after groin lymphadenectomy: a double institution observational study.
abstract: OBJECTIVE
  Postoperative morbidity associated with groin lymphadenectomy remain high and still represents a major concern for this patients. The aim of this study was to confirm the efficacy of TachoSil(®) in preventing postoperative complications after inguinofemoral lymphadenectomy for gynecological malignancy.
  
  
  METHODS
  An observational study was conducted to evaluate the incidence of postoperative complications among 49 patients (TachoSil(®) group=24; control group=25) underwent groin dissection enrolled in two Italian Department of Gynecology Oncology from 2011 to 2014.
  
  
  RESULTS
  A total of 74 inguinal dissections were performed. Bilateral groin dissection was performed in 25 patients (Tachosil group=10; group 2=15). Patients in TachoSil(®) group showed a lower daily drainage volume with a mean volume of 84 ml (range 30-465) vs. 143 ml (range -72 to 413) in the control group (p=.004), and a lower total drainage volume with a mean of 540 ml (range 90-930) vs. 900 ml (range 200-3270) for Tachosil and control group, respectively. A lower incidence of lymphocyst required drainage, cellulitis, wound infection and late lymphedema was observed in TachoSil group even without reaching statistical significance.
  
  
  CONCLUSIONS
  This observational study confirmed that the use of TachoSil(®) seems to be highly effective in reducing the rate of postoperative lymphorrea and postoperative complications after groin dissection in case of gynecological malignancies. Larger multicenter prospective study is advisable to validate our preliminary results.
authors.affiliation: Unit of Gynecologic Oncology Surgery, Department of Obstetrics and Gynecology, Italy; University of Milano-Bicocca, San Gerardo Hospital, Monza, Italy. Electronic address: ginoncmonza@gmail.com.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Buda
authors.affiliation: Obstetrics and Gynecology Unit, Division of Gynecologic Oncology, Usl 1 of Massa and Carrara, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ghelardi
authors.affiliation: Unit of Gynecologic Oncology Surgery, Department of Obstetrics and Gynecology, Italy; University of Milano-Bicocca, San Gerardo Hospital, Monza, Italy.
authors.forename: Robert
authors.initials: R
authors.lastname: Fruscio
authors.affiliation: Obstetrics and Gynecology Unit, Division of Gynecologic Oncology, Usl 1 of Massa and Carrara, Italy.
authors.forename: Fernando
authors.initials: F
authors.lastname: Guelfi
authors.affiliation: Unit of Gynecologic Oncology Surgery, Department of Obstetrics and Gynecology, Italy; University of Milano-Bicocca, San Gerardo Hospital, Monza, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: La Manna
authors.affiliation: Unit of Gynecologic Oncology Surgery, Department of Obstetrics and Gynecology, Italy; University of Milano-Bicocca, San Gerardo Hospital, Monza, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Dell'Orto
authors.affiliation: Unit of Gynecologic Oncology Surgery, Department of Obstetrics and Gynecology, Italy; University of Milano-Bicocca, San Gerardo Hospital, Monza, Italy.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Milani
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002481:Cellulitis / Q000517:prevention & control; D004338:Drug Combinations; D005260:Female; D005340:Fibrinogen / Q000627:therapeutic use*; D006119:Groin; D065386:Historically Controlled Study; D006801:Humans; D008197:Lymph Node Excision; D008209:Lymphedema / Q000517:prevention & control*; D008210:Lymphocele / Q000517:prevention & control*; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D013529:Surgical Wound Dehiscence / Q000517:prevention & control; D013530:Surgical Wound Infection / Q000517:prevention & control; D013917:Thrombin / Q000627:therapeutic use*; D014846:Vulvar Neoplasms / Q000601:surgery*
chemical_list: D004338:Drug Combinations; C518955:TachoSil; D005340:Fibrinogen; D013917:Thrombin
keywords: Collagen patch; Groin lymphadenectomy; Lymphorrea prevention; Sealant activity