The effect of fibrin glue on the postoperative lymphatic drainage after gastrectomy and D2 dissection: a randomized clinical trial

Introduction: Disturbance in the lymphatic drainage during D2 dissection is associated with significant morbidity. We aimed to assess the effect of fibrin glue on reduction of postoperative seroma formation. Methods: : Prospective double-blinded randomized clinical trial with forty patients in each study arm was conducted. All patients diagnosed, staged and became candidate for D2 dissection based on NCCN 2019 guideline for gastric cancer. Intervention group received 1 cc of IFABOND® applied to the surgical bed. Results: : The difference between study groups regarding age, gender, tumor stage was insignificant. (All p values > 0.05). The median of daily drainage volume was 120 milliliter with the first and the third interquartile being 75 and 210 milliliter, respectively for intervention group. The control group had median, the first and the third interquartile of 350, 290 and 420 milliliter. The difference between daily drainage volumes was statistically significant (p value < 0.001). The length of hospital stay was significantly different between two groups and intervention group were discharged sooner (median of 7 Vs 9 days, p value: 0.001). Conclusion: This study showed possible role of fibrin glue on reducing postoperative seroma formation after gastrectomy and D2 dissection.(IRCT20200710048071N1, 2020.08.16)