title: Prevention of lymphocele development in gynecologic cancers by the electrothermal bipolar vessel sealing device.
abstract: OBJECTIVE
  A number of new techniques have been developed to prevent lymphocele formation after pelvic lymphadenectomy in gynecologic cancers. We assessed whether the electrothermal bipolar vessel sealing device (EBVSD) could decrease the incidence of postoperative lymphocele secondary to pelvic lymphadenectomy.
  
  
  METHODS
  A total of 321 patients with gynecologic cancer underwent pelvic lymphadenectomy from 2005 to 2011. Pelvic lymphadenectomy without EBVSD was performed in 134 patients, and pelvic lymphadenectomy with EBVSD was performed in 187 patients. We retrospectively compared the incidence of lymphocele and symptoms between both groups.
  
  
  RESULTS
  Four to 8 weeks after operation, 108 cases of lymphocele (34%) were detected by computed tomography scan examination. The incidence of lymphocele after pelvic lymphadenectomy was 56% (75/134) in the tie ligation group, and 18% (33/187) in the EBVSD group. We found a statistically significant difference in the incidence of lymphocele between both groups (p<0.01). To detect the independent risk factor for lymphocele development, we performed multivariate analysis with logistic regression for three variables (device, number of dissected lymph nodes, and operation time). Among these variables, we found a significant difference (p<0.001) for only one device.
  
  
  CONCLUSIONS
  Use of the EBVSD during gynecological cancer operation is useful for preventing the development of lymphocele secondary to pelvic lymphadenectomy.
authors.affiliation: Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Japan.
authors.forename: Naotake
authors.initials: N
authors.lastname: Tsuda
authors.affiliation: Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Japan.
authors.forename: Kimio
authors.initials: K
authors.lastname: Ushijima
authors.affiliation: Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Japan.
authors.forename: Kouichiro
authors.initials: K
authors.lastname: Kawano
authors.affiliation: Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Japan.
authors.forename: Shuji
authors.initials: S
authors.lastname: Takemoto
authors.affiliation: Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Japan.
authors.forename: Shin
authors.initials: S
authors.lastname: Nishio
authors.affiliation: Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Japan.
authors.forename: Gounosuke
authors.initials: G
authors.lastname: Sonoda
authors.affiliation: Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Japan.
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Kamura
mesh_terms: D000328:Adult; D004564:Electrocoagulation / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005833:Genital Neoplasms, Female / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects / Q000379:methods*; D008207:Lymphatic Metastasis; D008210:Lymphocele / Q000209:etiology / Q000517:prevention & control*; D008875:Middle Aged; D009367:Neoplasm Staging; D010388:Pelvis; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Electrothermal bipolar vessel sealing device; Gynecologic cancer; LigaSure; Lymphocele; Pelvic lymphadenectomy; Venous thrombosis