Does fibrin glue improve drainage after axillary lymph node dissection? Prospective and randomized study in humans

Area of Science:

• Oncology
• Surgical Innovation
• Biomaterials in Medicine

Background:

• Axillary lymph node dissection (ALND) is a standard procedure for breast cancer staging.
• Post-operative fluid collection (lymphorrhea) and complications are common after ALND.
• Fibrin glue has been explored as a method to reduce fluid drainage and improve healing.

Purpose of the Study:

• To evaluate the efficacy of fibrin glue in reducing lymphorrhea after axillary lymph node dissection.
• To assess the impact of fibrin glue on complication rates and hospital stay following breast cancer surgery.

Main Methods:

• Prospective, randomized study involving 40 women undergoing breast cancer surgery.
• Patients were randomized into two groups: one receiving fibrin glue in the axillary dissection area (Group A) and a control group (Group B).
• Comparison of fluid drainage volume, duration, hospital stay, and complication rates between groups using statistical tests.

Main Results:

• Fibrin glue significantly increased lymphorrhea volume in the axillary dissection area (410.4 ml vs. 275.5 ml, p=0.016).
• No significant differences were observed in drainage volume at the mastectomy/lumpectomy site or total drainage volume.
• Complication rates were higher in the fibrin glue group (6 vs. 1, p=0.037).

Conclusions:

• Fibrin glue application after axillary lymph node dissection does not reduce overall fluid drainage.
• The use of fibrin glue in this context is associated with an increased risk of complications.
• Current evidence does not support the routine use of fibrin glue to manage lymphorrhea after ALND in breast cancer patients.