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Evaluating the importance of routine drainage following laparoscopic pelvic lymph node dissection for gynecological malignancies
Author(s) -
Sakai Kensuke,
Nakamura Masaru,
Yamagami Wataru,
Chiyoda Tatsuyuki,
Kobayashi Yusuke,
Nishio Hiroshi,
Hayashi Shigenori,
Nomura Hiroyuki,
Kataoka Fumio,
Tominaga Eiichiro,
Banno Kouji,
Aoki Daisuke
Publication year - 2021
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.13507
Subject(s) - medicine , laparotomy , laparoscopy , dissection (medical) , lymphedema , surgery , laparoscopic surgery , lymph node , medical record , general surgery , cancer , breast cancer
Objective To determine the efficacy of drainage following pelvic lymph node (PLN) dissection, especially for cases involving laparoscopic surgery. Methods In this retrospective study, 368 patients with malignant gynecological tumors who underwent systemic PLN dissection at Keio University Hospital between January 2012 and October 2018 were enrolled. Drainage tubes were placed in the retroperitoneal fossa in all patients. Medical records were used for data collection. Results Laparoscopy was performed on 81 patients, and laparotomy was performed on 287 patients. In the laparoscopy group, tubes were removed 1 day post surgery. In the laparotomy group, tubes were removed 1 day post surgery in 167 patients and 4 days post surgery in 120 patients. Compared with the laparotomy group, we determined the laparoscopy group to have a significantly lower prevalence of lymphocyst (6.2% vs 20.2%, p = 0.002) but a similar prevalence of lymphedema (4.9% vs 5.2%), and symptomatic lymphocyst (2.5% vs 4.5%). The two laparotomy groups did not differ significantly with respect to the prevalence of lymphedema (4.8% vs 5.8%), lymphocyst (20.4% vs 20.0%), or symptomatic lymphocyst (4.2% vs 5.0%). Conclusion Our results suggest that routine drainage should be omitted, especially in cases involving laparoscopic surgery.