[For and against the use of suction drainages after retroperitoneal lymph node dissection in oncogynecological surgery--summarized foreign and our own experience].
BACKGROUND
We evaluated and summarized our own and foreign experience in the use of suction drainages after retroperitoneal pelvic and paraaortal lymph node dissection, which prevented collections of clots or lymphocysts, as well as prevented postsurgical infections and postoperative fistulas. The invention of the new surgical techniques, nonclosure of the peritoneum, the antibiotic prophylaxis and anticoagulant therapy lead to reevaluation of the use of drainages after retroperitoneal lymph node dissection. The already performed worldwide prospective, retrospective and randomized clinical trials did not find difference between the use and not use of suction drainages. We tried to summarize the foreign experience in this scientific field, as well as our experience from the National Oncological Center in Sofia, the experience from the RHW - Sydney Australia, as well as the experience from the Medical University of Varna -Cathedra of Obst and Gynecology.


METHODS
We reviewed the literature for the period from 1987 to 2009 and tried to give our results in this area of science.


RESULTS
From 400 trials and studies we chose 14 which we examined in detail. We evaluated some complications as bleeding, fever, pelvic infections, fistulas and DVT. Our results did not find statistical difference between the drained and not drained group.


CONCLUSIONS
The routine application of suction retroperitoneal drainages after retroperitoneal lymph node dissection in the field of oncogynecology, maybe avoided with the only exceptions: after heavy intraoperative bleeding and suspecion for surgical traumas and fistulas.
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Ivanov
D005260:Female; D005833:Genital Neoplasms, Female / Q000601:surgery*; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods; D011183:Postoperative Complications / Q000517:prevention & control; D012187:Retroperitoneal Space / Q000601:surgery*; D013396:Suction / Q000009:adverse effects / Q000379:methods