Preventing lymphedema and morbidity with an omentum flap after ilioinguinal lymph node dissection.
BACKGROUND
Pedicled omentoplasty has been advocated to prevent the formation of lymphocysts and lymphedema after pelvic lymph node dissection, We evaluated the possible benefit of a pediculated omentoplasty placed in the groin for preventing complications after ilioinguinal lymph node dissection.


METHODS
In this pilot study, we report a series of four women and three men with inguinal metastatic lymph nodes. Each was treated with a pediculated omentoplasty after groin dissection. We examined complications such as lymphedema, lymphorrhea, wound breakdown, skin necrosis, and lymphocysts.


RESULTS
Only one wound breakdown with skin necrosis was observed, and it healed satisfactorily in 10 days without exposing the femoral vessels. No lymphocele or infectious complications occurred, even though no antibiotic prophylaxis was used. Midthigh circumference increase ranged from 1.5 to 7 cm in four cases but remained asymptomatic. Furthermore, lymphedema of the lower limb decreased in the three remaining patients, who previously had an enlargement of the thigh. No evidence of peritoneal carcinomatosis was noted during the 4-month follow-up.


CONCLUSIONS
Pedicled omentoplasty seemed to facilitate the absorption or transport of lymph fluids and resulted in less lymphedema in the lower limb even after radiotherapy. Pedicled omentoplasty reduces both short-term and long-term postoperative complications without affecting treatment outcome and could even be considered as a safe and effective therapy for lymphedema of the lower extremity.
Benoit
Laurent
L
Service de Chirurgie Digestive, Thoracique, et Cancérologique, CHU du Bocage, B.P. 77908, 21079, Dijon Cedex, France. laurent.benoit@chu-dijon.fr
Boichot
Christophe
C
Cheynel
Nicolas
N
Arnould
Laurent
L
Chauffert
Bruno
B
Cuisenier
Jean
J
Fraisse
Jean
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008196:Lymph / Q000378:metabolism; D008197:Lymph Node Excision / Q000009:adverse effects* / Q000379:methods*; D008207:Lymphatic Metastasis; D008209:Lymphedema / Q000209:etiology* / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D009852:Omentum / Q000601:surgery; D012867:Skin / Q000473:pathology; D013524:Surgical Flaps