{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T03:10:17Z","timestamp":1773285017748,"version":"3.50.1"},"reference-count":55,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2021,4,24]],"date-time":"2021-04-24T00:00:00Z","timestamp":1619222400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>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\u2019s 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 (p &lt; 0.0001, p &lt; 0.005, p = 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.<\/jats:p>","DOI":"10.3390\/cancers13092056","type":"journal-article","created":{"date-parts":[[2021,4,24]],"date-time":"2021-04-24T21:49:20Z","timestamp":1619300960000},"page":"2056","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Fibrin Sealants and Axillary Lymphatic Morbidity: A Systematic Review and Meta-Analysis of 23 Clinical Randomized Trials"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9482-9527","authenticated-orcid":false,"given":"Maria","family":"Gasparri","sequence":"first","affiliation":[{"name":"Department of Gynecology and Obstetrics, Ospedale Regionale di Lugano EOC, via Tesserete 46, 6900 Lugano, Switzerland"},{"name":"Faculty of Biomedical Sciences, Universit\u00e0 della Svizzera Italiana (USI), via Giuseppe Buffi 13, 6900 Lugano, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thorsten","family":"Kuehn","sequence":"additional","affiliation":[{"name":"Interdisciplinary Breast Center, Department of Gynecology and Obstetrics, Klinikum Esslingen, 73730 Neckar, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilary","family":"Ruscito","sequence":"additional","affiliation":[{"name":"Gynecology Division, Department of Medical and Surgical Sciences and Translational Medicine, Sant\u2019Andrea University Hospital, Sapienza University of Rome, via di Grottarossa 1035, 00189 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veronica","family":"Zuber","sequence":"additional","affiliation":[{"name":"Breast Surgery Unit, Department of Surgery, San Raffaele University Hospital, via Olgettina 60, 20132 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2575-8729","authenticated-orcid":false,"given":"Rosa","family":"Di Micco","sequence":"additional","affiliation":[{"name":"Breast Surgery Unit, Department of Surgery, San Raffaele University Hospital, via Olgettina 60, 20132 Milan, Italy"},{"name":"Department of Clinical Medicine and Surgery, University of Naples Federico II, 80138 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilaria","family":"Galiano","sequence":"additional","affiliation":[{"name":"Breast Surgery Unit, Department of Surgery, San Raffaele University Hospital, via Olgettina 60, 20132 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siobana","family":"Navarro Quinones","sequence":"additional","affiliation":[{"name":"Emory University, Atlanta, GA 30322, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Letizia","family":"Santurro","sequence":"additional","affiliation":[{"name":"Breast Surgery Unit, Department of Surgery, San Raffaele University Hospital, via Olgettina 60, 20132 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Di Vittorio","sequence":"additional","affiliation":[{"name":"Breast Surgery Unit, Department of Surgery, San Raffaele University Hospital, via Olgettina 60, 20132 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Meani","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Ospedale Regionale di Lugano EOC, via Tesserete 46, 6900 Lugano, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2864-7186","authenticated-orcid":false,"given":"Valerio","family":"Bassi","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Ospedale Regionale di Lugano EOC, via Tesserete 46, 6900 Lugano, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nina","family":"Ditsch","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, University Hospital of Augsburg, Stenglinstra\u00dfe 2, 86156 Augsburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1947-1315","authenticated-orcid":false,"given":"Michael","family":"Mueller","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University Hospital of Bern, Friedb\u00fchlstrasse 19, 3010 Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filippo","family":"Bellati","sequence":"additional","affiliation":[{"name":"Gynecology Division, Department of Medical and Surgical Sciences and Translational Medicine, Sant\u2019Andrea University Hospital, Sapienza University of Rome, via di Grottarossa 1035, 00189 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donatella","family":"Caserta","sequence":"additional","affiliation":[{"name":"Gynecology Division, Department of Medical and Surgical Sciences and Translational Medicine, Sant\u2019Andrea University Hospital, Sapienza University of Rome, via di Grottarossa 1035, 00189 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Papadia","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Ospedale Regionale di Lugano EOC, via Tesserete 46, 6900 Lugano, Switzerland"},{"name":"Faculty of Biomedical Sciences, Universit\u00e0 della Svizzera Italiana (USI), via Giuseppe Buffi 13, 6900 Lugano, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4489-1867","authenticated-orcid":false,"given":"Oreste","family":"Gentilini","sequence":"additional","affiliation":[{"name":"Breast Surgery Unit, Department of Surgery, San Raffaele University Hospital, via Olgettina 60, 20132 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1093\/jnci\/djj158","article-title":"Randomized Multicenter Trial of Sentinel Node Biopsy Versus Standard Axillary Treatment in Operable Breast Cancer: The ALMANAC Trial","volume":"98","author":"Mansel","year":"2006","journal-title":"J. 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