Predictors of Symptomatic Lymphocele After Lymph Node Excision and Radical Prostatectomy

Naselli, Angelo; Andreatta, Rossana; Introini, Carlo; Fontana, Vincenzo; Puppó, P.

doi:10.1016/j.urology.2009.03.011

Cited by 89 publications

(96 citation statements)

References 18 publications

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“…Although patients' age [9] and metastatic involvement of pelvic lymph node [5] have been reported as risk factors for symptomatic lymphocele formation, analysis of our patient cohort did not reveal a statistically significant correlation between these factors. Moreover, no other clinical and pathological factors influenced formation of symptomatic lymphoceles.…”

Section: Discussioncontrasting

confidence: 67%

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Influence of Body Mass Index, Surgical Approach and Lymphadenectomy on the Development of Symptomatic Lymphoceles after Radical Prostatectomy

et al. 2013

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Purpose: Identification of factors influencing lymphocele formation requiring intervention after radical prostatectomy. Methods: 302 patients undergoing radical retropubic prostatectomy (RRP, n = 174) or transperitoneal robot-assisted laparoscopic prostatectomy (RALP, n = 128) by the same surgeon were retrospectively reviewed. Incidence of symptomatic lymphoceles (SLC) was compared with clinical and pathological data (contingency analyses, Wilcoxon-Kruskal-Wallis test). Results: Sixteen patients (5.3%) developed SLC. SLC occurred significantly more frequently after RRP compared to RALP (8.0 vs. 0.8%, p = 0.0008). Patients with SLC had more lymph nodes (LN) removed median (17 vs. 13, p = 0.009) and a significantly lower BMI (median 24.4 vs. 26.4, p = 0.0008). Presence of LN metastases (n = 18 patients, 6.0%) showed no statistical impact on SLC. In a multivariate analysis surgical method, the number of resected LN and the BMI remained independent predictors of SLC formation. Conclusions: The lower incidence of SLC after RALP compared to RRP probably results from peritoneal drainage of lymphatic fluid. The correlation of removed LN and SLC might be explained by increased injury of lymphatic vessels during more extended LN dissection. Why patients with lower BMI are more prone to develop SLC still remains unclear. However, early postoperative mobilization in nonobese patients might be a contributing factor.

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Section: Discussioncontrasting

confidence: 67%

“…Overall complication rates vary from 1.2 to 17.7% [1,4]. The most frequent postoperative complications of PLND are lymphoceles, although not all lymphoceles need further surgical treatment and can be managed conservatively [3,5,6]. The incidence of lymphoceles is reported between 0.6 and 10.3% of the cases [4,7,8].…”

Section: Introductionmentioning

confidence: 99%

Influence of Body Mass Index, Surgical Approach and Lymphadenectomy on the Development of Symptomatic Lymphoceles after Radical Prostatectomy

et al. 2013

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“…Performing or not performing lymph node dissection is probably the most important predictor of lymphocele formation [5]. The extent of lymph node dissection is another risk factor with higher incidences after more extensive dissection [6]. In the current study, with 15 (open) and 13 (robot-assisted) procedures, the lymph node yield was higher than in comparable studies [5,7,] suggesting an increased risk of lymphocele development.…”

Section: Discussionmentioning

confidence: 58%

Perioperative Complications after Radical Prostatectomy: Open versus Robot-Assisted Laparoscopic Approach

Froehner¹,

Novotný²,

Koch

et al. 2013

Urol Int

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Background: The best technique of radical prostatectomy - open versus robot-assisted approach - is controversially discussed. In this study, we compared the complication rates of open and robot-assisted radical prostatectomy during the introduction and subsequent routine use of a da Vinci® robotic device while open surgery remained the standard approach. Patients and Methods: Between January 1st, 2006, and June 4th, 2012, 2,754 men underwent radical prostatectomy at our department. Among them, 317 received robot-assisted and 2,438 open surgery. According to the requirements for prostate cancer centers certified by the Deutsche Krebsgesellschaft (German Cancer Society), a prospective database recording perioperative complications was built up. The complication rates of open and robot-assisted radical prostatectomy were compared with the χ² or Fisher exact test. The distributions of quantitative variables were compared with U tests. Results: Whereas the demographic factors favored patients selected for robot-assisted radical prostatectomy, there were no differences between open and robot-assisted surgery concerning length of stay, autologous blood transfusion rates and the incidence of perioperative complications. Conclusions: Open and robot-assisted radical prostatectomy had comparable complication rates. With better patient- and tumor-related parameters as well as decreasing transfusion rates in the robot-assisted subgroup, this observation might reflect the learning curves of the involved robotic surgeons.

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“…6 The risk of lymphocele increases when a PLND is performed, especially if an extended template is used. 7 Lymphoceles are relatively common complications, although the exact incidence is unknown since most will resolve without ever being diagnosed. They are reported to occur in 0.1% to 2% of patients, with no significant differences between surgical approaches.…”

Section: Discussionmentioning

confidence: 99%

The deep vein thrombosis caused by lymphocele after endoscopic extraperitoneal radical prostatectomy and pelvic lymph node dissection

Park

Lee

Park

et al. 2013

CUAJ

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Pelvic lymphocele is a postoperative complications than can result after endoscopic extraperitoneal radical prostatectomy and pelvic lymph node dissection. Radical prostatectomy have many risk factors of deep vein thrombosis including location of target organ, malignancy, old age, Trendelenburg position, pelvic lymph node dissection, and long procedure time. A 57-year-old man with a localized prostate cancer was treated with endoscopic extraperitoneal radical prostatectomy and pelvic lymph node dissection. Deep vein thrombosis was detected as a first sign of pelvic lymphocele. Lymphocele was managed with a percutaneous drainage without sclerosant. We report a case of deep vein thrombosis due to pelvic lymphocele after endoscopic extraperitoneal radical prostatectomy.

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Predictors of Symptomatic Lymphocele After Lymph Node Excision and Radical Prostatectomy

Cited by 89 publications

References 18 publications

Influence of Body Mass Index, Surgical Approach and Lymphadenectomy on the Development of Symptomatic Lymphoceles after Radical Prostatectomy

Influence of Body Mass Index, Surgical Approach and Lymphadenectomy on the Development of Symptomatic Lymphoceles after Radical Prostatectomy

Perioperative Complications after Radical Prostatectomy: Open versus Robot-Assisted Laparoscopic Approach

The deep vein thrombosis caused by lymphocele after endoscopic extraperitoneal radical prostatectomy and pelvic lymph node dissection

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