title: Use of TachoSil® to Prevent Symptomatic Lymphocele after an Aggressive Tumor Debulking with Lymphadenectomy for Advanced Stage Ovarian Cancer. A Pilot Study.
abstract: OBJECTIVE
  To describe the incidence of symptomatic lymphocele (SLC) after an aggressive tumor debulking surgery and lymphadenectomy in patients with ovarian cancer and peritoneal carcinomatosis with or without TachoSil®.
  
  
  METHODS
  A pilot retrospective comparative observational study was performed between patients with advanced ovarian cancer International Federation of Gynecology and Obstetrics stages III-IV who underwent complete debulking surgery and radical retroperitoneal lymphadenectomy. In 18 patients, 4 TachoSil® patches were placed in the retroperitoneal area, since January 2014-October 2014. This group was compared with other 18 consecutive patients matched by age, International Federation of Gynecology and Obstetrics stage, surgical complexity, American Society of Anesthesiologists score, comorbidity, and BMI without the use of TachoSil®.
  
  
  RESULTS
  Baseline characteristics were similar between groups. There were no statistically significant differences in terms of surgical complexity, surgical time, estimated blood loss, node removed, length of hospital stay, and complications between groups. SLC was diagnosed in 7 patients (38.8%) without TachoSil®, and in 2 patients (11.1%) with TachoSil® (p = 0.121). The use of TachoSil® was associated with a statistically significant lower re-admission rate (p = 0.041) and with a significantly shorter time to adjuvant chemotherapy (p = 0.02).
  
  
  CONCLUSIONS
  Using TachoSil® in women with advanced stage ovarian cancer who underwent radical debulking with retroperitoneal lymph node dissection is associated with a non-statistically significant reduction in the incidence of SLC. A larger-scale randomized controlled study should be conducted to confirm our preliminary results.
authors.affiliation: Gynecology Department, Valencian Institute of Oncology (IVO), Valencia, Spain.
authors.forename: Lucas
authors.initials: L
authors.lastname: Minig
authors.forename: Maria Guadalupe
authors.initials: MG
authors.lastname: Patrono
authors.forename: Jose Miguel
authors.initials: JM
authors.lastname: Cárdenas-Rebollo
authors.forename: Pedro
authors.initials: P
authors.lastname: Martin Marfil
authors.forename: Virginia
authors.initials: V
authors.lastname: Rodriguez-Tabares
authors.forename: Linus
authors.initials: L
authors.lastname: Chuang
mesh_terms: D000368:Aged; D065426:Cytoreduction Surgical Procedures / Q000009:adverse effects*; D004338:Drug Combinations; D005260:Female; D005340:Fibrinogen / Q000008:administration & dosage*; D006801:Humans; D008137:Longitudinal Studies; D008210:Lymphocele / Q000209:etiology / Q000517:prevention & control*; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000473:pathology / Q000601:surgery*; D010534:Peritoneal Neoplasms / Q000473:pathology / Q000601:surgery*; D010865:Pilot Projects; D012189:Retrospective Studies; D015503:Surgical Sponges; D013917:Thrombin / Q000008:administration & dosage*
chemical_list: D004338:Drug Combinations; C518955:TachoSil; D005340:Fibrinogen; D013917:Thrombin