Retroperitoneal drainage after complete Para-aortic lymphadenectomy for gynecologic cancer: a randomized trial.
OBJECTIVE
To determine the relationship between retroperitoneal drainage after complete para-aortic lymphadenectomy for gynecologic cancer and subsequent development of lymphocysts.


METHODS
Eighty women undergoing complete para-aortic lymphadenectomy up to the level of the left renal vein for ovarian (n = 43) or cervical carcinoma (n = 37) were randomly assigned to receive drainage or no drainage of the para-aortic area. Most of patients had pelvic drainage. Abdominopelvic ultrasonography was done 8 to 12 days after surgery. Postoperative complications, duration of hospital stay, and characteristics of asymptomatic lymphocysts were studied.


RESULTS
Forty-two women had para-aortic drainage and 38 did not. Complications occurred in 15 patients who had drainage and in 5 patients who did not have drainage (36% versus 13%; P <.02). Three patients (8%) in the undrained group had complications potentially related to drainage (symptomatic lymphocysts or ascites) compared with 11 (26%) in the drained group (chi(2) = 4.6; P <.05). Median duration of the hospital stay was 9 days in the undrained group and 11 days in the drained group (P <.03). The number of asymptomatic para-aortic lymphocysts detected during the ultrasonography was 9 (24%) in the undrained and 2 (5%) in the drained group (chi(2) = 4.6; P <.05).


CONCLUSIONS
The number of asymptomatic para-aortic lymphocysts was higher in patients who did not undergo drainage, but morbidity and the duration of hospitalization were increased in these patients. Routine drainage of the retroperitoneum after para-aortic lymphadenectomy should be abandoned.
Morice
P
P
Department of Gynecologic Surgery, Imaging, Oncology and Radiotherapy, Institut Gustave Roussy, Villejuif, France. morice@igr.fr  
Lassau
N
N
Pautier
P
P
Haie-Meder
C
C
Lhomme
C
C
Castaigne
D
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D001012:Aorta, Abdominal; D004322:Drainage; D005260:Female; D005833:Genital Neoplasms, Female / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008197:Lymph Node Excision; D008210:Lymphocele / Q000209:etiology; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000601:surgery; D011182:Postoperative Care; D011183:Postoperative Complications / Q000209:etiology; D012187:Retroperitoneal Space; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000601:surgery