Fibrin Sealants and Axillary Lymphatic Morbidity: A Systematic Review and Meta-Analysis of 23 Clinical Randomized Trials

• Main 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
• Format: Article
• Language: English
• Published: MDPI AG 2021-04-01
• Series: Cancers
• Subjects: axillary lymphadenectomy; breast cancer; fibrin sealant; lymphatic morbidity; lymphocele
• Online Access: https://www.mdpi.com/2072-6694/13/9/2056

Background: use of fibrin sealants following pelvic, paraaortic, and inguinal lymphadenectomy may reduce lymphatic morbidity. The aim of this meta-analysis is to evaluate if this finding applies to the axillary lymphadenectomy. Methods: randomized trials evaluating the efficacy of fibrin sealants in reducing axillary lymphatic complications were included. Lymphocele, drainage output, surgical-site complications, and hospital stay were considered as outcomes. Results: twenty-three randomized studies, including patients undergoing axillary lymphadenectomy for breast cancer, melanoma, and Hodgkin’s disease, were included. Fibrin sealants did not affect axillary lymphocele incidence nor the surgical site complications. Drainage output, days with drainage, and hospital stay were reduced when fibrin sealants were applied (<i>p</i> < 0.0001, <i>p</i> < 0.005, <i>p</i> = 0.008). Conclusion: fibrin sealants after axillary dissection reduce the total axillary drainage output, the duration of drainage, and the hospital stay. No effects on the incidence of postoperative lymphocele and surgical site complications rate are found.