Category: Laparoscopic/ Robotic: Prostate
Introduction & Objective :
Extended pelvic lymph node dissection (ePLND) after robot assisted radical prostatectomy (RARP) may lead to increased lymphatic drainage, delay in drain removal time and prolonged hospital stay. The aim of this study was to evaluate the effect of fibrin glue on lymphatic drainage in RARP with ePLND.
Methods : A total number of 40 patients who underwent transperitoneal RARP with ePLND were prospectively evaluated.Twenty consecutive patients treated with the autologous fibrin glue (Vivostat™) enrolled to group 1, another 20 who did not recieve to group 2.Approximately 4ml of fibrin glue was applied on each side of lymph node dissection areas.Age, body-mass index, daily drainage volume and harvested lymph nodes were compared. Patients with major pelvic surgery and radiotherapy were excluded from the study.
Results : There was not statistically significant difference between the groups respect to age, body-mass index and the number of harvested lymph nodes.There was not any advers effect related to fibrin glue.The drain volume after postoperative 24 hours were similar between the groups( 87,5ml vs 90ml; p = 0.636).The daily drain volume of group 1 was statistically lower when compared to group 2 at postoperative 24-48 hours(105ml vs 210ml; p = 0.027) and 48-72 hours (75ml vs 280ml; p < 0.0001) (Table and Figure).Total volume of drain was 277 ml in group 1 wheras 570 ml in group 2 (p = 0.01).
Conclusions : Application of autologous fibrin glue reduces lymphatic drainage after ePLND in men with RARP. Decreased lymphatic drainage may lead to early drain removal and reduce hospital stay.
OMER AYTAC– urologist, Istanbul Florence Nightingale Hospital Groups, Istanbul, Istanbul, Turkey
Asgar Garayev– assistant professor, Istanbul Bilim University, Istanbul, Istanbul, Turkey
Fatih Atug– professor, Istanbul Bilim University, Istanbul, Istanbul, Turkey
Istanbul Florence Nightingale Hospital Groups
Istanbul, Istanbul, Turkey