title: How can lymphocele development be prevented after laparoscopic radical prostatectomy?
abstract: OBJECTIVE
  Lymphocele development is the most frequently reported postoperative complication of pelvic lymph node dissection (PLND) performed with laparoscopic radical prostatectomy (LRP). This study evaluated the efficacy of a vessel-sealing device (VSD) for the prevention of lymphocele development.
  
  
  METHODS
  A total of 120 patients who underwent LRP with PLND were prospectively enrolled. The patients were randomly assigned to one of the two groups: PLND using a conventional technique (group 1), and PLND performed with VSD (group 2). All patients underwent computed tomography (CT) scanning 1 month postoperatively to evaluate the maximum sectional area of the lymphoceles.
  
  
  RESULTS
  Lymphoceles developed in 63 cases (52.5%). One case (0.8%) was symptomatic with infection, and drainage tube placement was required. In the other 62 patients, the lymphoceles developed asymptomatically and were detected by CT scanning. There was no significant difference in the lymphocele development ratio between the two groups. However, when we defined a lymphocele over 1500 mm(2) as being a significant size, lymphoceles were present in 16 of 60 patients in group 1 and 4 of 60 patients in group 2. The incidence of significant lymphoceles over 1500 mm(2) in the group using VSD was much lower than that of the group without VSD (p<0.01). Multivariate analysis demonstrated that VSD was the only independent factor that had an effect on preventing the development of lymphoceles over 1500 mm(2) (p<0.01, odds ratio=4.96).
  
  
  CONCLUSIONS
  The results indicate that the development of large lymphoceles can be prevented by using VSD in LRP with PLND.
authors.affiliation: Department of Urology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Yota
authors.initials: Y
authors.lastname: Yasumizu
authors.forename: Akira
authors.initials: A
authors.lastname: Miyajima
authors.forename: Takahiro
authors.initials: T
authors.lastname: Maeda
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Takeda
authors.forename: Masanori
authors.initials: M
authors.lastname: Hasegawa
authors.forename: Takeo
authors.initials: T
authors.lastname: Kosaka
authors.forename: Eiji
authors.initials: E
authors.lastname: Kikuchi
authors.forename: Mototsugu
authors.initials: M
authors.lastname: Oya
mesh_terms: D000368:Aged; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008210:Lymphocele / Q000209:etiology* / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011468:Prostatectomy / Q000009:adverse effects*