Suzuki M, Ohwada M, Sato I
Department of Obstetrics and Gynecology, Jichi Medical School, Kawachi, Tochigi, Japan.
J Surg Oncol. 1998 Jul;68(3):149-52. doi: 10.1002/(sici)1096-9098(199807)68:3<149::aid-jso3>3.0.co;2-5.
Pelvic lymphocysts have been reported mainly following pelvic lymphadenectomy for cervical cancer. We attempted to assess whether retroperitoneal partial "no-closure" reduces the incidence of lymphocyst formation following retroperitoneal lymphadenectomy.
Sixty-one patients with ovarian cancer or endometrial cancer who underwent retroperitoneal lymph node resection were assigned at random to a retroperitoneal partial "no-closure" group or a "closure" group. The incidence of lymphocysts in the two groups as determined using ultrasonography was compared.
Lymphocysts appeared in 23/61 patients (38%) in total. In the "closure" group, the incidence was 52% (16/31), but in the "no-closure" group it was only 23% (7/30); the incidence in the "no-closure" group was significantly lower (P < 0.05). The incidence of postoperative fever was 17% (5/30) in the "no-closure" group, which was lower than that in the "closure" group (42%, 13/31), but not significantly so (P < 0.1). No patients in the "no-closure" group required surgical procedures such as needle aspiration or cyst drainage.
Retroperitoneal partial "no-closure" appears to be a useful procedure for reducing the incidence of pelvic lymphocysts associated with retroperitoneal lymphadenectomy.
盆腔淋巴管囊肿主要在宫颈癌盆腔淋巴结清扫术后被报道。我们试图评估腹膜后部分“不缝合”是否能降低腹膜后淋巴结清扫术后淋巴管囊肿的发生率。
61例行腹膜后淋巴结切除术的卵巢癌或子宫内膜癌患者被随机分为腹膜后部分“不缝合”组或“缝合”组。比较两组中通过超声检查确定的淋巴管囊肿发生率。
61例患者中共有23例（38%）出现淋巴管囊肿。“缝合”组的发生率为52%（16/31），而“不缝合”组仅为23%（7/30）；“不缝合”组的发生率显著更低（P < 0.05）。“不缝合”组术后发热发生率为17%（5/30），低于“缝合”组（42%，13/31），但差异无统计学意义（P < 0.1）。“不缝合”组中无患者需要针吸或囊肿引流等外科手术。
腹膜后部分“不缝合”似乎是一种降低与腹膜后淋巴结清扫术相关的盆腔淋巴管囊肿发生率的有效方法。
