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[Radical prostatectomy and biologic glue].

B Lobel1, O Ordonez, J F Olivo

  • 1Service d'Urologie, C.H.R.U., Rennes, France.

Progres En Urologie : Journal De L'Association Francaise D'Urologie Et De La Societe Francaise D'Urologie
|June 1, 1991
PubMed
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Fibrin glue did not improve outcomes after radical prostatectomy, failing to reduce drainage, lymphatic oozing, or hospital stay. Its routine use is not recommended due to increased costs and lack of demonstrated benefits in surgical hemostasis.

Area of Science:

  • Urology
  • Surgical Innovation
  • Biomaterials

Background:

  • Radical prostatectomy often involves lymphadenectomy, leading to challenges in hemostasis and lymphatic drainage.
  • Fibrin glue has been explored as an adjunct to improve surgical outcomes in various procedures.

Purpose of the Study:

  • To evaluate the efficacy of fibrin glue in improving hemostasis, reducing lymphatic ooze, and promoting urethrovesical anastomosis healing after radical prostatectomy with ilio-obturator lymphadenectomy.
  • To compare outcomes between patients treated with fibrin glue and a control group.

Main Methods:

  • A comparative study involving 48 patients undergoing radical prostatectomy with ilio-obturator lymphadenectomy.
  • Group I (24 patients) received standard surgical care; Group II (24 patients) received fibrin glue in addition to standard care.

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  • Outcomes assessed included drainage duration, fluid volume, complications, and hospital stay.

    • Main Results:

    • Fibrin glue use resulted in a dry operative field and no infectious complications.
    • However, it did not significantly reduce drainage time, blood/lymphatic discharge volume, or length of hospital stay compared to the control group.
    • The cost of fibrin glue was noted as a significant increase.

    Conclusions:

    • Fibrin glue does not offer significant clinical benefits in reducing drainage or hospital stay following radical prostatectomy with lymphadenectomy.
    • The increased cost associated with fibrin glue outweighs its limited advantages in this surgical context.
    • Routine use of fibrin glue in radical prostatectomy is not supported by these findings.