Angelica Conversano1, Chafika Mazouni2, Anne Thomin1, Amélie Gaudin3, Marie Fournier1, Françoise Rimareix1, Julia Bonastre4. 1. Division of Breast and Plastic Surgery, Department of Surgery, Gustave Roussy, Villejuif, France. 2. Division of Breast and Plastic Surgery, Department of Surgery, Gustave Roussy, Villejuif, France. Electronic address: chafika.mazouni@gustaveroussy.fr. 3. Department of Pharmacy, Gustave Roussy, Villejuif, France. 4. Service de Biostatistique et d'Epidémiologie, Gustave Roussy, Villejuif, France; CESP Centre for Research in Epidemiology and Population Health, INSERM U1018, Paris-Sud University, Villejuif, France.
Abstract
BACKGROUND: Axillary lymphadenectomy for primary breast cancer produces a non-negligible rate of postoperative lymphorrhea, prolonged hospital stays, and multiple seroma punctures. We evaluated the impact of low-thrombin fibrin sealant glue on surgical wounds in patients undergoing axillary lymph node dissection for breast cancer. METHODS: We conducted an observational study of 149 patients who underwent axillary lymphadenectomy for primary breast cancer between January 2014 and December 2015. Data were obtained from 2 successive prospective studies. The hospital stay length and morbidity (seromas, punctures) were compared between 2 groups: patients who had padding sutures and low-thrombin fibrin sealant glue without drainage (n = 49) and patients with drainage alone (n = 100). Hospital costs were assessed from the hospital perspective. RESULTS: The mean hospital stay length was shorter in the fibrin sealant group (2.6 vs. 4.7 days; P < .001). Seroma magnitude and punctures were similar in patients treated with fibrin sealant compared with patients with drainage alone. The rate of needle aspiration for seroma was similar irrespective of whether or not a drain or fibrin sealant was used (30.6% vs. 33.0%, P = .77). CONCLUSION: Low-thrombin fibrin sealant glue does not significantly reduce the amount of fluid produced in the axilla after breast surgery; however, its systematic use may help reduce hospital stays and costs.
BACKGROUND: Axillary lymphadenectomy for primary breast cancer produces a non-negligible rate of postoperative lymphorrhea, prolonged hospital stays, and multiple seroma punctures. We evaluated the impact of low-thrombin fibrin sealant glue on surgical wounds in patients undergoing axillary lymph node dissection for breast cancer. METHODS: We conducted an observational study of 149 patients who underwent axillary lymphadenectomy for primary breast cancer between January 2014 and December 2015. Data were obtained from 2 successive prospective studies. The hospital stay length and morbidity (seromas, punctures) were compared between 2 groups: patients who had padding sutures and low-thrombin fibrin sealant glue without drainage (n = 49) and patients with drainage alone (n = 100). Hospital costs were assessed from the hospital perspective. RESULTS: The mean hospital stay length was shorter in the fibrin sealant group (2.6 vs. 4.7 days; P < .001). Seroma magnitude and punctures were similar in patients treated with fibrin sealant compared with patients with drainage alone. The rate of needle aspiration for seroma was similar irrespective of whether or not a drain or fibrin sealant was used (30.6% vs. 33.0%, P = .77). CONCLUSION: Low-thrombin fibrin sealant glue does not significantly reduce the amount of fluid produced in the axilla after breast surgery; however, its systematic use may help reduce hospital stays and costs.
Authors: Maria Luisa Gasparri; Thorsten Kuehn; Ilary Ruscito; Veronica Zuber; Rosa Di Micco; Ilaria Galiano; Siobana C Navarro Quinones; Letizia Santurro; Francesca Di Vittorio; Francesco Meani; Valerio Bassi; Nina Ditsch; Michael D Mueller; Filippo Bellati; Donatella Caserta; Andrea Papadia; Oreste D Gentilini Journal: Cancers (Basel) Date: 2021-04-24 Impact factor: 6.639