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Advances in Urology
Volume 2016 (2016), Article ID 2367432, 7 pages
Research Article

Evaluation of Lymphorrhea and Incidence of Lymphoceles: 4DryField® PH in Radical Retropubic Prostatectomy

Division of Urology, Loretto-Krankenhaus, Mercystraße 6-14, 79100 Freiburg, Germany

Received 10 February 2016; Revised 18 April 2016; Accepted 15 May 2016

Academic Editor: Mohammad H. Ather

Copyright © 2016 Johannes-J. Karsch et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Purpose. To investigate impact of polysaccharide hemostat 4DryField PH (4DF) applied on lymph node dissection area after radical retropubic prostatectomy (RRP) on lymphorrhea and lymphocele (LC) formation. Methods. 104 consecutive patients underwent RRP, 51 without 4DF treatment (CT-group) and 53 with 4DF treatment (4DF-group). Groups were comparable (age, risk profile, and lymph node numbers). Postoperative drain loss (PDL) and development of early and late LC were analyzed (mean follow-up at 7 months: 100%). Results. PDL was 452.5 ± 634.2 mL without and 308.5 ± 214 mL with 4DF treatment. PDL > 1000 mL only occurred in CT-group (5/51). Overall, 45 LC (26 in CT- versus 19 in the 4DF-group) were diagnosed. At day 8, LC were equally distributed between groups. Incidence of late LC, however, was twice in controls (16/51) versus 4DF-patients (8/53). Symptomatic LC (4 in untreated patients, 2 in 4DF-patients) were treated with percutaneous drainage (duration: 45 days in untreated patients versus 12 days in 4DF-patients). Conclusion. Application of 4DF on lymph node dissection areas lessened total drain loss and significantly lowered high volume drain loss. Furthermore, 4DF reduced frequency of late lymphoceles and lymphoceles requiring treatment by half, as well as duration of percutaneous drainage by more than two-thirds.