Distribution of lymphocele following lymphadenectomy in patients with gynecological malignancies

Abstract

Objective This study identified the distribution of lymphocele, as well as the factors associated with lymphocele formation, in patients undergoing pelvic and/or para-aortic lymph node dissection (PLND and/or PALND) for gynecologic malignancies. Methods This study was retrospective, and data were collected from patients who underwent surgical procedures including lymphadenectomy due to gynecologic malignancies from March 2013 to May 2016. Lymphocele was defined by postoperative computer tomography within 2 weeks after surgery. Results A total of 116 patients underwent lymphadenectomy, of whom, 47 (42.0%) developed lymphocele and 14 (12.1%) had symptomatic lymphocele formation. The affecting factors of lymphocele formation were PLND concomitant with PALND and a large amount of blood loss ≥600 mL (P=0.030 and P=0.006, respectively). All clinical factors were not significantly different between patients with symptomatic and asymptomatic lymphocele. Lymphocele developed more frequently in the left side (67.1%) of the body compared to the right side (48.7%), and in the pelvic area (75.9%) compared to the para-aortic area (24.1%, P<0.001, both). Conclusion Lymphocele formation is more prevalent in the left and pelvic area of the body compared to the right and paraaortic side. PLND concurrent with PALND and large amounts of blood loss were significant risk factors for lymphocele formation.

Laparoscopic systemic restaging surgery for women with unexpected uterine malignancy

“…However, laparoscopic restaging surgery should be performed by experienced surgeons to prevent postoperative complications. Additionally, lymphadenectomy increases the risk for higher risk of surgery-related morbidity, lymphedema, and lymphocysts [ 27 ].…”

Does intraoperative application of TachoSil reduce the number of lymphoceles after pelvic lymphadenectomy?

“…Indeed, in the group of patients with clinically symptomatic lymphocele, complaints associated with the presence of lymphocele normally result from the mechanism of compression of the surrounding anatomical structures and depend on the location and size of the lesions [1,2,6]. Song et al [9], indicate that there is a correlation between the number of removed lymph nodes and the incidence of lymphocele [9], with the risk of being higher in patients with more lymph nodes removed (37.3 v 29.2; p < 0.02). Tinelli et al [1], and Achouri et al [14], add that the possibility of lymphocele diagnosis should be considered after lymphadenectomy in gynecological malignancy, especially when BMI is higher than 25 kg/m 2 , a broad lymphadenectomy has been undertaken, metastatic lymph nodes have been indicated, the patient is receiving heparin prophylaxis, lymphatic ligation failure has occurred, open surgery versus laparoscopy was applied, chemotherapy and radiotherapy has been administered.…”

FloSeal for preventing symptomatic lymphocele after pelvic and/or para-aortic lymphadenectomy in gynecological cancers: a randomized controlled trial

“…The most frequently reported postoperative complication of lymph node dissection is lymphocele (also known as lymphocyst) or lymphatic ascites (also known as chylous ascites). Among patients who have had a lymph node dissection for gynecological cancers, lymphocele or lymphatic ascites occurs in 57% patients [1][2][3][4][5][6][7]. Lymphoceles may compromise the quality of life of patients and delay adjuvant chemotherapy or radiotherapy following surgical intervention.…”