title: Impact of Surgical Route in Influencing the Risk of Lymphatic Complications After Ovarian Cancer Staging.
abstract: Lymphatic complications are a common occurrence after staging surgery for early-stage ovarian cancer (eEOC). We investigated whether the introduction of minimally invasive surgery influences the risk of developing lymphoceles and lymphorrhea in patients undergoing staging for eEOC. For this purpose, data of consecutive patients affected by eEOC undergoing staging surgery between January 1980 and January 2016 were retrospectively reviewed, and a systematic review and meta-analysis was performed. This systematic review was registered in the International Prospective Register of Systematic Review. Among 341 patients included in the present study, 47 severe postoperative complications occurred (13.7%), including 40 lymphatic complications: 31 symptomatic lymphoceles (9%) and 9 cases of lymphorrhea (2.6%), respectively. Laparoscopic staging correlated with a lower risk of developing any severe lymphatic complications in comparison with open surgery (p = .02). In particular, the laparoscopic approach and para-aortic node involvement were associated with a trend toward lower lymphoceles (odds ratio, .13; 95% confidence interval, .07-2.20; p = .05) and a trend toward higher risk of lymphorrhea developing (odds ratio, 4.02; 95% confidence interval, .93-17.3; p = .06), respectively. In conclusion, the implementation of a minimally invasive approach might result in a slight reduction of lymphatic complications after eEOC staging.
authors.affiliation: Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Bogani
authors.affiliation: Department of Obstetrics and Gynecology, Sant'Anna University Hospital, Ferrara, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Borghi
authors.affiliation: Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Ditto
authors.affiliation: Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Signorelli
authors.affiliation: Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Martinelli
authors.affiliation: Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Chiappa
authors.affiliation: Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy.
authors.forename: Cono
authors.initials: C
authors.lastname: Scaffa
authors.affiliation: Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Perotto
authors.affiliation: IRCCS AOU San Martino, Genoa, Italy; Departments of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Leone Roberti Maggiore
authors.affiliation: Department of Obstetrics and Gynecology, San Gerardo Hospital, Monza, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Montanelli
authors.affiliation: Department of Obstetrics and Gynecology, University La Sapienza, Rome, Italy.
authors.forename: Violante
authors.initials: V
authors.lastname: Di Donato
authors.affiliation: Department of Obstetrics and Gynecology, Ospedale di Polistena, Reggio Calabria, Italy.
authors.forename: Carmelo
authors.initials: C
authors.lastname: Infantino
authors.affiliation: Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy. Electronic address: domenica.lorusso@istitutotumori.mi.it.
authors.forename: Domenica
authors.initials: D
authors.lastname: Lorusso
authors.affiliation: Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Raspagliesi
mesh_terms: D000077216:Carcinoma, Ovarian Epithelial; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008197:Lymph Node Excision / Q000009:adverse effects* / Q000379:methods* / Q000706:statistics & numerical data; D008198:Lymph Nodes / Q000473:pathology; D008206:Lymphatic Diseases / Q000453:epidemiology / Q000209:etiology*; D042601:Lymphatic Vessels / Q000473:pathology; D008210:Lymphocele / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000706:statistics & numerical data; D009367:Neoplasm Staging / Q000009:adverse effects* / Q000379:methods; D009375:Neoplasms, Glandular and Epithelial / Q000453:epidemiology / Q000473:pathology*; D010051:Ovarian Neoplasms / Q000453:epidemiology / Q000473:pathology*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*
keywords: Laparoscopy; Lymphoceles; Lymphorrhea; Ovarian cancer; Staging