fibrin and Adenoma

Various surgical methods to prevent postoperative cerebrospinal fluid (CSF) leaks during transsphenoidal surgery have been reported. However, comparative studies are scarce. We aimed to compare the efficacy of a fibrin-coated collagen fleece (TachoSil) versus a dural sealant (DuraSeal) to prevent postoperative CSF leakage. We perform a retrospective study comparing two methods of sellar closure during endoscopic endonasal transsphenoidal surgery (EETS) for pituitary adenoma resection: TachoSil patching versus DuraSeal packing. Data concerning diagnosis, reconstruction technique, and surgical outcomes were analyzed. The primary endpoint was postoperative CSF leak rate. We reviewed 198 consecutive patients who underwent 219 EETS for pituitary adenoma from February 2007 and July 2018. Intraoperative CSF leak occurred in 47 cases (21.5%). A total of 33 postoperative CSF leaks were observed (15.1%). A reduction of postoperative CSF leaks in the TachoSil application group compared to the conventional technique using Duraseal was observed (7.7% and 18.2%, respectively; p = 0.062; Pearson exact test) although non-statistically significant. Two patients required lumbar drainage, and no revision repair was necessary to treat postoperative CSF rhinorrhea in Tachosil group. Fibrin-coated collagen fleece patching may be a valuable method to prevent postoperative cerebrospinal fluid (CSF) leaks during EETS for pituitary adenoma resection.

Topics: Adenoma; Cerebrospinal Fluid Leak; Collagen; Fibrin; Humans; Pituitary Diseases; Pituitary Neoplasms; Postoperative Complications; Retrospective Studies

Parotidectomy leaves a retromandibular hollow area in proportion with the amount of gland resected. Many surgeons perform primary reconstruction after superficial or subtotal parotidectomy in patients with exo-facial pleiomorphic focal adenoma. Many techniques have been proposed. We present a new technique of filling of the parotidectomy chamber by a second generation leucocyte and platelet concentrate, Platelet-Rich Fibrin (PRF, Choukroun's method).. 10 patients were included in this preliminary study. Subtotal parotidectomy was performed through classic procedure or lifting procedure. The macroscopic security margin of resection usually allowed performance of a SMAS flap. PRF was prepared following the original Choukroun's method.. PRF slow resorption after filling of the exeresis cavity, offers a key aesthetic interest. The fibrin matrix of this biomaterial has many angiogenic and healing properties. Synergetic action of the fibrin and the platelets cytokines within PRF may improve revascularization and postoperative resumption of facial nerve function. The membrane formed by the fibrin dense fibrillary network, as well as the SMAS flap, may help to prevent the Frey's syndrome.. We propose the use of PRF as a filling, healing and interposition material after parotidectomy for benign parotid tumors. Preliminary results are very encouraging. Longer prospective evaluation of this technique is necessary.

Topics: Adenoma; Adult; Biocompatible Materials; Blood Platelets; Fibrin; Humans; Middle Aged; Otorhinolaryngologic Surgical Procedures; Parotid Neoplasms; Plastic Surgery Procedures; Surgical Flaps

A commercially available monoclonal antibody against human fibrin was used to detect fibrin in canine formalin-fixed, paraffin wax-embedded tissue by applying a slightly modified alkaline phosphatase anti-alkaline phosphatase (APAAP) technique. Twenty-eight mammary tumours from six bitches were examined for the presence of fibrin. Thrombi and extravascular fibrin deposits were detected in 15 tumours (12 complex adenocarcinomas, one adenocarcinoma, two solid carcinomas), and a single thrombus was detected in one adenoma; 12 tumours (three adenomas, one complex adenoma, four complex adenocarcinomas and four adenocarcinomas) did not show any staining reaction.

Topics: Adenocarcinoma; Adenoma; Animals; Antibodies, Monoclonal; Carcinoma; Dogs; Female; Fibrin; Immunohistochemistry; Mammary Neoplasms, Animal; Necrosis; Thrombosis

Topics: Adenoma; Carcinoma; Culture Media; Culture Techniques; Cyclohexanecarboxylic Acids; Fibrin; Fibrinogen; Fibrinolysis; Fibroma; Granuloma; Granuloma, Giant Cell; Hemangioma; Humans; Methylamines; Mouth Neoplasms; Neoplasms, Muscle Tissue

Topics: Adenocarcinoma; Adenoma; Adrenal Gland Neoplasms; Breast Diseases; Breast Neoplasms; Female; Fibrin; Fluorescent Antibody Technique; Genital Neoplasms, Female; Hodgkin Disease; Humans; Lymph Nodes; Lymphatic Diseases; Melanoma; Methods; Neoplasms; Neoplasms, Nerve Tissue; Ovarian Neoplasms; Sarcoma; Stomach Neoplasms; Thyroid Neoplasms; Tuberculosis