title: Prevention of lymphocele by using gelatin-thrombin matrix as a tissue sealant after pelvic lymphadenectomy in patients with gynecologic cancers: a prospective randomized controlled study.
abstract: OBJECTIVE
  This prospective randomized controlled pilot study aimed to find whether gelatin-thrombin matrix used as a tissue sealant (FloSeal) can prevent the occurrence of pelvic lymphocele in patients with gynecologic cancer who has undergone pelvic lymphadenectomy.
  
  
  METHODS
  Each patient, who undergo a laparotomic pelvic lymph node dissection on both sides, was randomly assigned for FloSeal application on 1 side of the pelvis. The other side of the pelvis without any product application being the control side. The amount of lymph drainage at each side of the pelvis was measured for 3 days, and computed tomography scans were obtained 7 days and 6 months after surgery for detection of pelvic lymphocele.
  
  
  RESULTS
  Among 37 cases, the median amount of lymph drainage was significantly decreased in the hemi-pelvis treated with FloSeal compared to the control hemi-pelvis (p=0.025). The occurrence of lymphocele was considerably reduced in treated hemi-pelvis (8/37, 21.6%) compared with control hemi-pelvis (12/37, 32.4%) after 7 post-operative days (p=0.219), and more decreased in the treated hemi-pelvis (5/37, 13.5%) compared with control hemi-pelvis (9/37, 24.3%) after postoperative 6 months (p=0.344).
  
  
  CONCLUSIONS
  The application of FloSeal as a tissue sealant in lymph nodes resected tissues can reduce the incidence of pelvic lymphocele in gynecologic cancer patients. A large randomized controlled study could confirm these preliminary results.
authors.affiliation: Department of Obstetrics and Gynecology, Ewha Womans University School of Medicine, Seoul, Korea. kimyhmd@ewha.ac.kr.
authors.forename: Yun Hwan
authors.identifier: http://orcid.org/0000-0001-9498-2938
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Hyun Joo
authors.identifier: http://orcid.org/0000-0002-5359-9251
authors.initials: HJ
authors.lastname: Shin
authors.affiliation: Department of Obstetrics and Gynecology, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Woong
authors.identifier: http://orcid.org/0000-0002-0013-8304
authors.initials: W
authors.lastname: Ju
authors.affiliation: Department of Obstetrics and Gynecology, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Seung Cheol
authors.identifier: http://orcid.org/0000-0002-5000-9914
authors.initials: SC
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D004322:Drainage; D005260:Female; D005781:Gelatin Sponge, Absorbable / Q000627:therapeutic use*; D005833:Genital Neoplasms, Female / Q000601:surgery*; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects* / Q000379:methods; D008210:Lymphocele / Q000517:prevention & control*; D008875:Middle Aged; D010388:Pelvis / Q000601:surgery; D010865:Pilot Projects; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies
chemical_list: C411004:FloSeal Matrix
keywords: Drainage; Genital Neoplasms, Female; Lymph Node Excision; Lymphocele; Secondary Prevention; Surgical Oncology