A prospective study of postoperative lymphedema after surgery for cervical cancer.
OBJECTIVE
Lymphedema is a severe postoperative complication in oncological surgery. Multifrequency bioelectrical impedance analysis (MFBIA) is a new method for early lymphedema detection. The objective was to establish the methodology of MFBIA for lower-limb lymphedema and to detect a lymphedema in patients undergoing cervical cancer surgery.


METHODS
From a population of 60 patients undergoing cervical cancer surgery, 39 underwent radical hysterectomy Wertheim III (RAD group), and 21 underwent conservative surgery (laparoscopic lymphadenectomy plus simple trachelectomy/simple hysterectomy--CONS group). A control group of 29 patients (CONTR group) was used to determine the SD of impedance at zero frequency (R0). Patients were examined before surgery and at 3 and 6 months after surgery by MFBIA and by measuring the circumference of the lower limbs.


RESULTS
No differences were found between the CONS and RAD groups on age, height, weight, and histopathologic type of tumor. However, the number of dissected lymph nodes differed significantly between the groups (17.3 in the CONS group vs 25.8 in the RAD group, P = 0.0012). The SD of R0 in the CONTR group was 36.0 and 39.0 for the right and the left leg, respectively. No difference in prevalence of lymphedema based on circumference method was found (35.9% in the RAD and 47.6% in the CONS groups, not statistically significant).


CONCLUSIONS
No difference in the prevalence of lymphedema was found between the CONS and RAD groups. A methodology for MFBIA for the detection of lower-limb lymphedema was described.
Halaska
Michael J
MJ
Department of Obstetrics and Gynaecology, 2nd Medical Faculty of the Charles University in Prague and Faculty Hospital Motol, Prague, Czech Republic. mhalaska@centrum.cz
Novackova
Marta
M
Mala
Ivana
I
Pluta
Marek
M
Chmel
Roman
R
Stankusova
Hana
H
Robova
Helena
H
Rob
Lukas
L
D000230:Adenocarcinoma / Q000601:surgery* / Q000628:therapy; D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000601:surgery* / Q000628:therapy; D042241:Early Diagnosis; D017097:Electric Impedance; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000379:methods; D035002:Lower Extremity; D008197:Lymph Node Excision / Q000009:adverse effects* / Q000379:methods; D008209:Lymphedema / Q000175:diagnosis* / Q000209:etiology; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000601:surgery* / Q000628:therapy