The Role of Tachosil® in Lymphostasis After Systematic Mediastinal Lymphadenectomy in Lung Cancer Patients

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Tomasz Jaroslaw Szczesny
Department of Thoracic Surgery, Oncology Center in Bydgoszcz, Bydgoszcz
Izabela Kubiszewska
Department of Immunology, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, Bydgoszcz
Agnieszka Rybak
Department of Microbiology, Oncology Center in Bydgoszcz, Bydgoszcz
Jacek Michalkiewicz
Department of Immunology, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, Bydgoszcz; Department of Clinical Microbiology and Immunology, Children's Memorial Health Institute, Warsaw
Maria Szymankiewicz
Department of Microbiology, Oncology Center in Bydgoszcz, Bydgoszcz
Maciej Dancewicz
Department of Thoracic Surgery, Oncology Center in Bydgoszcz, Bydgoszcz; Department of Thoracic Surgery, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, Bydgoszcz
Mariusz Bella
Department of Thoracic Surgery, Oncology Center in Bydgoszcz, Bydgoszcz; Department of Thoracic Surgery, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, Bydgoszcz
Janusz Kowalewski
Department of Thoracic Surgery, Oncology Center in Bydgoszcz, Bydgoszcz; Department of Thoracic Surgery, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, Bydgoszcz

Abstract

Objectives: Results of prospective randomized study to assess the influence of Tachosil® applied on mediastinum after systematic lymphadenectomy are presented.

Material and methods: In 28 patients from the Tachosil® group 1 to 3 large pieces of Tachosil® (mean 1.8, SD±0.7) were applied, while in 22 patient from the control group only coagulation was allowed. Clinical data were collected, and pleural concentrations of IL-6, IL-1ra and IL-8 on postoperative days 1, 2 and 3 were measured, with ELISA method.

Results: Both groups were well balanced according to sex, age, number of packyears of cigarettes, time from smoking cessation, pulmonary function test results, concomitant diseases, BMI index, number of N1 and N2 nodes resected, and perioperative serum concentrations of IL-6, IL-1ra and L-8. Postoperative complications occurred in 8/29 and 12/24 patients from each group (p=0.046), respectively, with no mortality. No differences in time of surgery, intraoperative blood loss, amount of drainage and drainage hemoglobin concentration on postoperative days 1, 2 and 3, time to drainage removal and number of blood units transfused between the groups were observed. The summarized postoperative pleural drainage was lower in the Tachosil® group (p=0.03). Concentration of IL-6 in pleural drainage was higher in the Tachosil® group on the first (p=0.01) and the second (p=0.03) postoperative days. Positive correlation between number of blood units transfused and pleural concentration of hemoglobin on subsequent postoperative days in the whole group but not in Tachosil® group was found.

Conclusions: This study showed a significant impact of application of Tachosil® on mediastinum after systematic lymphadenectomy on clinical outcome due to decreased amount of total postoperative drainage and decreased rate of complications. A higher concentration of IL-6 in pleural fluid on postoperative day 1 and 2 may reflect a minor local immune response to Tachosil®, without elevation of concentration of other cytokines and without negative impact on postoperative complications. Blood transfusions in patients from the Tachosil® group were rather due to preoperative anemia and intraoperative blood loss, unlike in the control group where blood transfusions were rather due to postoperative blood loss with pleural drained fluid.

Article Details

How to Cite
SZCZESNY, Tomasz Jaroslaw et al. The Role of Tachosil® in Lymphostasis After Systematic Mediastinal Lymphadenectomy in Lung Cancer Patients. Medical Research Archives, [S.l.], v. 4, n. 6, oct. 2016. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/595>. Date accessed: 17 nov. 2024.
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Keywords
lung cancer, lymphadenectomy, postoperative complications, IL-6, IL-1ra, IL-8, Tachosil
Issue
Vol 4 No 6 (2016): Vol. 4 issue 6, October,2016
Section
Research Articles

The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.

 

References

1 Lardinois D, De Leyn P, Van Schil P, Porta RR, Waller D, Passlick B, Zielinski M, Lerut T, Weder W. ESTS guidelines for intraoperative lymph node staging in non-small cell lung cancer. Eur J Cardiothorac Surg. 2006;30:787-92.

2 Leschber G, Holinka G, Linder A. Video-assisted mediastinoscopic lymphadenectomy (VAMLA)--a method for systematic mediastinal lymphnode dissection. Eur J Cardiothorac Surg. 2003;24:192-5.

3 Lardinois D, Suter H, Hakki H, Rousson V, Betticher D, Ris HB. Morbidity, survival, and site of recurrence after mediastinal lymph-node dissection versus systematic sampling after complete resection for non-small cell lung cancer. Ann Thorac Surg. 2005;80:268-74; discussion 274-5.

4 Izbicki JR, Thetter O, Habekost M, Karg O, Passlick B, Kubuschok B, Busch C, Haeussinger K, Knoefel WT, Pantel K, Schweiberer L. Radical systematic mediastinal lymphadenectomy in non-small cell lung cancer: a randomized controlled trial. Br J Surg. 1994;81:229-35.

5 Author et al. 2007

6 Czerny M, Fleck T, Salat A, Zimpfer D, Klepetko W, Wolner E, Mueller MR. Sealing of the mediastinum with a local hemostyptic agent reduces chest tube duration after complete mediastinal lymph node dissection for stage I and II non-small cell lung carcinoma. Ann Thorac Surg. 2004;77:1028-32.

7 Shimamoto T, Marui A, Nishina T, Saji Y, Komeda M. The TachoSil-Pledget stitch: towards eradication of suture hole bleeding. Ann Thorac Surg. 2008;86:2002-4.

8 Anegg U, Lindenmann J, Matzi V, Smolle J, Maier A, Smolle-Jüttner F. Efficiency of fleece-bound sealing (TachoSil) of air leaks in lung surgery: a prospective randomised trial. Eur J Cardiothorac Surg. 2007;31:198-202.

9 Yim AP, Wan S, Lee TW, Arifi AA. VATS lobectomy reduces cytokine responses compared with conventional surgery. Ann Thorac Surg. 2000; 70:243-7.

10 Keller SM, Adak S, Wagner H, Johnson DH. Mediastinal lymph node dissection improves survival in patients with stages II and IIIa non-small cell lung cancer. Eastern Cooperative Oncology Group. Ann Thorac Surg. 2000;70:358-65; discussion 365-6.

11 Watanabe Y, Shimizu J, Oda M, Hayashi Y, Tatsuzawa Y, Watanabe S, Yoshida M, Iwa T.
Improved survival in left non-small-cell N2 lung cancer after more extensive operative procedure. Thorac Cardiovasc Surg. 1991;39:89-94.

12 Darling GE, Allen MS, Decker PA, Ballman K, Malthaner RA, Inculet RI, Jones DR, McKenna RJ, Landreneau RJ, Rusch VW, Putnam JB Jr. Randomized trial of mediastinal lymph node sampling versus complete lymphadenectomy during pulmonary resection in the patient with N0 or N1 (less than hilar) non-small cell carcinoma: results of the American College of Surgery Oncology Group Z0030 Trial. J Thorac Cardiovasc Surg.2011;141:662-70.

13 Lardinois D, Suter H, Hakki H, Rousson V, Betticher D, Ris HB. Morbidity, survival, and site of recurrence after mediastinal lymph-node dissection versus systematic sampling after complete resection for non-small cell lung cancer. Ann Thorac Surg. 2005;80:268-74; discussion 274-5.

14 Huang J, Luo Q, Shentu Y, Zhao X. Prevention of refractory cough with mediastinal fat to fill the residual cavity after radical systematic mediastinal lymphadenectomy in patients with right lung cancer. Zhongguo Fei Ai Za Zhi. 2010;13:975-9.

15 Buda A, Ghelardi A, Fruscio R, Guelfi F, La Manna M, Dell'Orto F, Milani R The contribution of a collagen-fibrin patch (Tachosil) to prevent the postoperative lymphatic complications after groin lymphadenectomy: a double institution observational study. Eur J Obstet Gynecol Reprod Biol. 2016 Feb;197:156-8. doi: 10.1016/j.ejogrb.2015.12.005.

16 Grimm C, Polterauer S, Helmy S, Cibula D, Zikan M, Reinthaller A, Tempfer C. A collagen-fibrin patch (Tachosil®) for the prevention of symptomatic lymphoceles after pelviclymphadenectomy in women with gynecologic malignancies: a randomized clinical trial. BMC Cancer. 2014 Aug 30;14:635. doi: 10.1186/1471-2407-14-635.

17 Minig L, Patrono MG, Cárdenas-Rebollo JM, Martin Marfil P, Rodriguez-Tabares V, Chuang L Use of TachoSil® to Prevent Symptomatic Lymphocele after an Aggressive Tumor Debulking with Lymphadenectomy for Advanced Stage Ovarian Cancer. A Pilot Study. Gynecol Obstet Invest. 2016 Apr 6. [Epub ahead of print]

18 Navarro-Rodríguez E, Gómez-Luque I, Díaz-Jiménez N, Rioja-Torres P, Bascuñana-Estudillo G, Ruiz-Rabelo JF, Ciria-Bru R, Álvarez-Benito M, Rufián-Peña S, Briceño-Delgado J Effectiveness of an absorbable fibrin sealant patch to reduce lymphoceles formation after axillary lymphadenectomy for breast cancer: a matched-pair analysis. Am J Surg. 2014 Nov;208(5):824-30. doi: 10.1016/j.amjsurg.2013.12.041.