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Effects of Fibrin Sealant on Seroma Reduction for Patients with Breast Cancer Undergoing Axillary Dissection: Meta-Analysis of Randomized Controlled Trials

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Seroma formation is common in patients with breast cancer after axillary dissection. Fibrin sealant, containing fibrinogen and thrombin, has been developed to improve wound healing. We conducted a systematic review and meta-analysis to evaluate the efficacy of fibrin sealants in reducing seroma among patients with breast cancer undergoing axillary dissection.

Methods

We searched the PubMed, EMBASE, and Cochrane Library databases for randomized controlled trials (RCTs) published up to April 2020. Pooled estimates of the outcomes were computed using a random-effects model. The primary outcomes were incidence and volume of seroma, while the secondary outcomes were volume and duration of drainage, incidence of infection, and length of hospital stay.

Results

We reviewed 23 RCTs that included 1640 patients. Compared with the control group, the fibrin sealant group had no significant differences in the incidence of seroma, length of hospital stay, or incidence of surgical site infection. Significant intergroup differences were discovered in lower volume of seroma (weighted mean difference [WMD] − 71.88, 95% confidence interval [CI] − 135.58 to − 8.19), volume of drainage (WMD − 73.24, 95% CI − 107.32 to − 39.15), and duration of drainage (WMD − 0.84, 95% CI − 1.50 to − 0.19).

Conclusions

Fibrin sealants provide limited benefits in reducing the volume of seroma and the volume and duration of drainage. Therefore, after shared decision making, surgeons may apply fibrin sealants to patients with breast cancer undergoing axillary dissection.

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Acknowledgment

This manuscript was edited by Wallace Academic Editing.

Funding

This work was supported by a research grant from Yuan’s General Hospital and Taipei Medical University (grant no. 108YGH-TMU-06). The sponsoring organization was not involved in the study design, data analysis, or interpretation of the results.

Author information

Author notes

  1. Ya-Ting Chang and Shen-Liang Shih contributed equally to this work.

Authors and Affiliations

  1. School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

    Ya-Ting Chang MS

  2. Cancer Center, Yuan’s General Hospital, Kaohsiung, Taiwan

    Shen-Liang Shih MD, MSc

  3. Department of Health Business Administration, Meiho University, Pingtung, Taiwan

    Shen-Liang Shih MD, MSc

  4. Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

    El-Wui Loh PhD

  5. Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan

    El-Wui Loh PhD & Ka-Wai Tam MD, PhD

  6. Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan

    El-Wui Loh PhD & Ka-Wai Tam MD, PhD

  7. Division of General Surgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

    Ka-Wai Tam MD, PhD

  8. Division of General Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan

    Ka-Wai Tam MD, PhD

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  1. Ya-Ting Chang MS
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Correspondence to Ka-Wai Tam MD, PhD.

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Ya-Ting Chang, Shen-Liang Shih, El-Wui Loh, and Ka-Wai Tam have no conflicts of interest or financial ties to disclose.

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Chang, YT., Shih, SL., Loh, EW. et al. Effects of Fibrin Sealant on Seroma Reduction for Patients with Breast Cancer Undergoing Axillary Dissection: Meta-Analysis of Randomized Controlled Trials. Ann Surg Oncol 27, 5286–5295 (2020). https://doi.org/10.1245/s10434-020-08747-5

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  • DOI: https://doi.org/10.1245/s10434-020-08747-5

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