Effectiveness of TissuGlu in Reducing Seroma Formation and Postoperative Recovery in Mastectomy Patients: A Systematic Review and Meta-Analysis of Comparative Studies.

IF 2.9 3区医学 Q2 ONCOLOGY

Clinical breast cancer Pub Date : 2025-03-26 DOI:10.1016/j.clbc.2025.03.014

Daniel Madarshahian, Kwaku Duah-Asante, Hadyn Kn Kankam, Joanna Skillman

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引用次数: 0

Abstract

Postmastectomy complications, especially seroma formation, pose significant challenges to recovery and patient outcomes. TissuGlu, a lysine-urethane-based tissue adhesive, has been proposed as an alternative to standard wound closure (SWC) with drains to reduce seroma incidence and enhance recovery. However, its effectiveness remains debated. This meta-analysis assesses TissuGlu's impact compared to SWC in postmastectomy wound management. Following PRISMA guidelines, a systematic review and meta-analysis were conducted, including randomized controlled trials (RCTs) and observational studies published through August 2024 from databases including PubMed, Cochrane Library, Google Scholar, Embase, and Scopus. Six studies involving 408 patients (450 mastectomies) met inclusion criteria. Results indicated a significantly higher seroma incidence in the TissuGlu group than SWC (OR = 2.57, 95% CI, 1.20-5.52, P = .02), while no significant difference was observed in the number of mastectomies requiring aspiration (OR = 1.01, 95% CI, 0.29-3.51, P = .98). SWC showed benefits in fewer aspirations per mastectomy (WMD = 0.87, P = .003) and reduced aspiration volume (WMD = 110.83 mL, P = .04). TissuGlu notably reduced hospital stays (WMD = -2.44 days, P < .00001), suggesting improved recovery times. While SWC may better control postoperative fluid accumulation, TissuGlu holds promise in minimizing drain duration. Further high-quality RCTs are needed to establish the optimal role of TissuGlu, potentially in conjunction with drains, for improved postmastectomy outcomes.

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TissuGlu减少乳房切除术患者血清形成和术后恢复的有效性：比较研究的系统回顾和荟萃分析。

乳房切除术后的并发症，尤其是血清瘤的形成，对患者的康复和预后构成了重大挑战。TissuGlu是一种以赖氨酸-氨基脲为基础的组织胶粘剂，已被提出作为标准伤口闭合（SWC）的替代方法，用于引流，以减少血肿的发生率并提高恢复。然而，其有效性仍存在争议。本荟萃分析评估了TissuGlu与SWC在乳房切除术后伤口处理中的影响。遵循PRISMA指南，进行了系统评价和荟萃分析，包括随机对照试验（rct）和观察性研究，发表于2024年8月的数据库包括PubMed、Cochrane Library、谷歌Scholar、Embase和Scopus。涉及408例患者（450例乳房切除术）的6项研究符合纳入标准。结果显示，TissuGlu组的血肿发生率明显高于SWC组（OR = 2.57, 95% CI, 1.20-5.52, P = 0.02），而需要穿刺的乳房切除术数量无显著差异（OR = 1.01, 95% CI, 0.29-3.51, P = 0.98）。SWC在每次乳房切除术减少吸入量（WMD = 0.87, P = 0.003）和减少吸入量（WMD = 110.83 mL, P = 0.04）方面显示出益处。TissuGlu显著减少住院时间（WMD = -2.44天，P < 0.00001），表明恢复时间缩短。SWC可以更好地控制术后液体积聚，TissuGlu有望缩短引流时间。需要进一步的高质量随机对照试验来确定TissuGlu的最佳作用，可能与引流管联合使用，以改善乳房切除术后的预后。

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来源期刊

Clinical breast cancer 医学-肿瘤学

CiteScore

5.40

自引率

3.20%

发文量

174

审稿时长

48 days

期刊介绍： Clinical Breast Cancer is a peer-reviewed bimonthly journal that publishes original articles describing various aspects of clinical and translational research of breast cancer. Clinical Breast Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of breast cancer. The main emphasis is on recent scientific developments in all areas related to breast cancer. Specific areas of interest include clinical research reports from various therapeutic modalities, cancer genetics, drug sensitivity and resistance, novel imaging, tumor genomics, biomarkers, and chemoprevention strategies.