Pennehouat G, Mosseri V, Durand J C, Hamelin J P, Asselain B, Pilleron J P, Salmon R J
Service de chirurgie générale, Institut Curie, Paris.
J Gynecol Obstet Biol Reprod (Paris). 1988;17(3):373-8.
Pelvic lymphocysts following lymphadenectomy in the management of cervical and corporeal uterine carcinoma are recorded in one third of the cases and require surgery in 2-3% of cases. In order to prevent these lymphocysts, peritoneal suturing in front of the lymph node dissection area was progressively abandoned in order to allow peritoneal resorption of the lymph. A retrospective study analysed 226 iliac lymphadenectomies between 1982-1986 for uterine cancer treated at the Institut Curie. 220 patients received peritoneal suturing, while 46 patients were not sutured. The incidence of lymphocysts was respectively 35.9% and 17.4%. The difference is statistically significant (p = 0.01). The "no suture" technique lowered the incidence and the severity of lymphocysts. No side effect of the "no suture" technique was recorded. Multivariate analysis demonstrated that lymphocysts were significantly related to the side of the cancer in the cervix (p = 0.0001), to the preventive use of heparin (p = 0.0025) and to suturing the peritoneum with suction drainage (p = 0.004). We conclude that after pelvic lymphadenectomy the "no suture" technique for the peritoneum reduces the incidence of lymphocysts in the majority of patients.
