Gasparri Maria Luisa, Ruscito Ilary, Bolla Daniele, Benedetti Panici Pierluigi, Mueller Michael D, Papadia Andrea
*Department of Gynecology, Obstetrics and Urology, Sapienza University of Rome, Rome, Italy; and †Department of Obstetrics and Gynecology, University Hospital of Berne, University of Berne, Berne, Switzerland.
Int J Gynecol Cancer. 2017 Jul;27(6):1283-1292. doi: 10.1097/IGC.0000000000001051.
Although pivotal in the oncological management of most tumors, radical lymphadenectomy is associated with a significant number of lymphatic complications. The aim of this meta-analysis is to evaluate the efficacy of fibrinogen sealant patches in reducing lymphadenectomy-related postoperative complications.
METHODS/MATERIALS: The electronic databases PubMed, Medline, and Scopus were searched using the terms "lymphadenectomy" or "lymph node dissection" and "TachoSil," "TachoComb," or "fibrin sealant patch." Series evaluating the efficacy of fibrin-thrombin collagen sealant patches were included in the meta-analysis.
Overall, 26 studies were retrieved through the literature search. Ten studies including 720 patients met selection criteria. The use of fibrin-thrombin sealant patches to the sole scope of reducing lymphadenectomy-related complications significantly reduced the incidence of lymphocele, symptomatic lymphocele, the need of percutaneous drainage procedures, the volume of lymph drained, and the duration of the drainage. No effect on wound and/or lymphocele infection was noted.
This meta-analysis demonstrates that the use of fibrin-thrombin sealant patches significantly reduces the total volume of lymph drained, the duration of the drainage, the incidence of lymphocele and symptomatic lymphocele, and the need for postoperative percutaneous drainage procedures. Its use does not affect the incidence of wound or lymphocele infections.
尽管根治性淋巴结清扫术在大多数肿瘤的肿瘤学治疗中起着关键作用，但它会引发大量淋巴相关并发症。本荟萃分析的目的是评估纤维蛋白原封闭剂贴片在减少淋巴结清扫术相关术后并发症方面的疗效。
方法/材料：使用 “淋巴结清扫术” 或 “淋巴结切除术” 以及 “TachoSil”、“TachoComb” 或 “纤维蛋白封闭剂贴片” 等术语检索电子数据库PubMed、Medline和Scopus。评估纤维蛋白 - 凝血酶胶原蛋白封闭剂贴片疗效的系列研究被纳入荟萃分析。
总体而言，通过文献检索共检索到26项研究。10项研究（包括720例患者）符合入选标准。使用纤维蛋白 - 凝血酶封闭剂贴片单纯用于减少淋巴结清扫术相关并发症，显著降低了淋巴囊肿、症状性淋巴囊肿的发生率、经皮引流操作的需求、引流量以及引流持续时间。未发现对伤口和/或淋巴囊肿感染有影响。
本荟萃分析表明，使用纤维蛋白 - 凝血酶封闭剂贴片可显著减少引流量、引流持续时间、淋巴囊肿和症状性淋巴囊肿的发生率以及术后经皮引流操作的需求。其使用不影响伤口或淋巴囊肿感染的发生率。
