Clinical surgery-InternationalSealants after axillary lymph node dissection for breast cancer: good intentions but bad results
Section snippets
Patients and Methods
A prospective, randomized study was conducted between October 2003 and November 2005 in the Breast Cancer Unit of the Department of Surgical Oncology of our hospital.
Results
Four surgeons operated on 77 consecutive patients with breast cancer. Pathologic preoperative confirmation existed for all patients. Mean patient age was 55.5 ± 12.0 (range 33 to 79). Seventy patients underwent lumpectomy plus ALND (90.9%), and 7 patients underwent ALND only (9.1%). The incidence of wound infection (primarily mild erythema) and lymphocele formation was 24.7% and 11.7%, respectively.
The 3 groups were matched for age and BMI. The majority underwent lumpectomy and ALND for stage
Comments
Compared with previous studies related to the use of sealants after axillary surgery, the results of this study are characterized by some unique properties. COSEAL and BioGlue are commercially available sealants and have been used in different settings but never after ALND for breast cancer. Previous studies have used fibrin glue, but the sealing effect needed to decrease postsurgical drainage can also be achieved by different products. We excluded patients who had undergone mastectomy (often
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Cited by (22)
The achilles heel of minimally invasive inguinal lymph node dissection: Seroma formation: Seroma MILND
2020, American Journal of SurgeryCitation Excerpt :Unfortunately, direct comparisons of seroma rates in MILND with open ILND is not reliable, as the open technique is associated with a high incidence of wound dehiscence, a complication that is seldom encountered following MILND and would need to be excluded for an accurate comparison. Although the exact mechanism is not entirely clear, several strategies have been investigated, such as, plugging lymphatic channels with topical fibrin sealants,5,16 avoiding deep lymphatic disruption by preservation of the muscular fascia,17 the use of tissue sealing devices to occlude lymphatics,18–20 saphenous vein preservation,21,22 quilting sutures to reduce dead space,23–25 and lymphatic mapping with isosulfan blue for the management of postoperative lymphoceles.26 Although many of these interventions showed initial promise, the literature regarding these techniques has showed mixed results.
Interest of a thrombin and fibrinogen combipatch in preventing breast cancer seroma after lymph node dissection
2013, Gynecologie Obstetrique et FertiliteLanreotide autogel 90 mg and lymphorrhea prevention after axillary node dissection in breast cancer: A phase III double blind, randomized, placebo-controlled trial
2012, European Journal of Surgical OncologyCitation Excerpt :It includes lymphorrhea from the damaged lymph vessels, local inflammation increasing the permeability of the lymphatic capillaries, a surgically created dead space filled with serous fluid and anticoagulant administration.2–4 Many attempts have been made to prevent seroma formation, including suction drains, external compressive dressings, shoulder immobilisation, fibrin glue, careful haemostasis and lymphostasis and axillary padding.5–10 Despite all these measures, lymphorrhea and seroma formation still cannot be avoided.
Sealants after axillary lymph node dissection
2012, American Journal of SurgeryEvidence for practice
2009, AORN Journal