[Influences of lymphatic vessel ligation in pelvic lymphadenectomy on postoperative lymphocyst formation--a randomized controlled trial].
OBJECTIVE
Pelvic lymphocysts are the most common postoperative complications of pelvic lymphadenectomy. Prevention of this disease is more important than treatment. This randomized study was to evaluate the preventive effect of lymph vessel ligation during pelvic lymphadenectomy on pelvic lymphocyst formation.


METHODS
A total of 39 patients with gynecologic malignancy, who had pelvic lymphadenectomy in the Second Affiliated Hospital of Sun Yat-sen University from July 2006 to January 2007, were randomized into the ligation group (19 patients) and the non-ligation group (20 patients). All patients had no heart disease, hepatopathy, nephronia, pneumonopathy, hypoproteinemia and no history of radiotherapy. All the patients were followed-up with sonographic evaluation and physical examination for lymphocysts and other postoperative complications at 1, 4, 12, and 24 weeks after operation.


RESULTS
No significant differences were observed between the two groups in pathlogic type, age, height, weight, body surface area, body mass index (BMI), operation duration, estimated blood loss, time to the passage of flatus, total drainage volume, duration of drainage, and duration of hospital stay (P>0.05). The occurrence rate of lymphocysts was significantly lower in the ligation group than in the non-ligation group at one week after operation (26.3% vs. 60.0%, P<0.05). The rates were slightly lower in the ligation group than in the non-ligation group without significant differences after then (31.6% vs. 55.0% at the 4th week), (16.7% vs. 45.0% at the 12th week), (20.0% vs. 27.8% at the 24th week). No significant differences were observed in the occurrence of other postoperative complications between the two groups (P<0.05).


CONCLUSIONS
Ligations of the deep inguinal lymph vessels, obturator lymph vessels, common iliac lymph vessels, and the lymph vessels at the crossing of the external iliac and the inter iliac vein can decrease the occurrence of postoperative lymphocysts in short-term period, and will not increase the occurrence of postoperative complications.
Lu
Huai-Wu
HW
Department of Gynecology and Obstetrics, The Second Affiliated Hospital, Sun Yat-sen University, Guangdong, P. R. China.
Zhou
Hui
H
Peng
Yong-Pai
YP
Zhang
Bing-Zhong
BZ
Lu
Xiao-Mei
XM
Wang
Li-Juan
LJ
Lin
Zhong-Qiu
ZQ
D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008026:Ligation / Q000009:adverse effects; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000601:surgery; D042601:Lymphatic Vessels / Q000601:surgery*; D008210:Lymphocele / Q000000981:diagnostic imaging / Q000209:etiology*; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000601:surgery; D010388:Pelvis; D014463:Ultrasonography; D002583:Uterine Cervical Neoplasms / Q000601:surgery*