Title
Author
DOI
Article Type
Special Issue
Volume
Issue
Clinical application of greater omentum plasty and fixation to prevent lymphocysts after lymphadenectomy in early-stage cervical cancer
1Department of gynaecology, Jiaxing Maternity and Child Health Care Hospital, 31400 Jiaxing, Zhejiang, China
DOI: 10.22514/ejgo.2023.007 Vol.44,Issue 1,February 2023 pp.62-67
Submitted: 25 May 2022 Accepted: 19 August 2022
Published: 15 February 2023
*Corresponding Author(s): Xuedong Tang E-mail: dangxuedong123@163.com
To explore the clinical effects of omentum plasty and fixation in the preventing the formation of lymphcysts and lower limb edema after lymphatic dissection of cervical cancer. The method we adopted is, a retrospective analysis was performed based on the clinicopathological data of patients with early cervical cancer who underwent extensive total hysterectomy, with pelvic lymph node dissection and omentum shaping and fixation at the Jiaxing Maternity and Child Health Care Hospital from January 2019 to January 2021. Greater omentum plasty and fixation was performed in 7 early-stage cervical cancer patients. The mean operation time was (210.71 ± 14.56) min, and had a recorded blood loss of 258.57 ± 39.77 mL, 18.14 ± 3.58 resected lymph nodes, 273.14 ± 34.50 mL postoperative abdominal drainage volume and 36.55 ± 2.12 g/L postoperative serum albumin. No lymphocysts were found on B-scan ultrasound reexamination one month after the surgery. However, 6 months post surgery asymptomatic Lymphatic cyst was identified via B-ultrasound in one patient but had no signs of lower extremity edema and intestinal obstruction. We found that Omentum shaping and fixation could reduce the risk of postoperative lymphatic cyst occurrence and infection pelvic lymphatic cyst and lower limb edema by absorbing the leaking lymph through the omentum. The operation was found to be safe and feasible in short-term follow-up, but long-term complications should be further explored to validate the clinical reliability of this procedure.
Omentum plasty; Fixation; Cervical cancer; Lymphatic cyst edema; Intestinal obstruction
Jianqing Zhou,Xuedong Tang. Clinical application of greater omentum plasty and fixation to prevent lymphocysts after lymphadenectomy in early-stage cervical cancer. European Journal of Gynaecological Oncology. 2023. 44(1);62-67.
[1] Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians. 2018; 68: 394–424.
[2] Chen W, Zheng R, Baade PD, Zhang S, Zeng H, Bray F, et al. Cancer statistics in China, 2015. CA: A Cancer Journal for Clinicians. 2016; 66: 115–132.
[3] Achouri A, Huchon C, Bats AS, Bensaid C, Nos C, Lécuru F. Complications of lymphadenectomy for gynecologic cancer. European Journal of Surgical Oncology. 2013; 39: 81–86.
[4] Zikan M, Fischerova D, Pinkavova I, Slama J, Weinberger V, Dusek L, et al. A prospective study examining the incidence of asymptomatic and symptomatic lymphoceles following lymphadeneetomy in patients with gynecological cancer. Gynecologic Oncology. 2015; 137: 291–298.
[5] Rutledge F, Dodd GD, Kasilag FB. Lymphocysts: a complication of radical pelvic surgery. American Journal of Obstetrics and Gynecology. 1959; 77: 1165–1175.
[6] Wang L. Analysis of the influencing factors of pelvic lymphocyst after radical hysterectomy for stage Ia IIa cervical cancer. Shandong Medical Journal. 2018; 58: 73–75. (In Chinese)
[7] Pan MX, Wang YM, Yan Y, Wang Q, Jiang S, Han C, et al. The risk factors analysis of lymphocele after pelvic lymphadenectomy in patients with endometrial cancer. Chinese Journal of Practical Gynecology and Obstetrics. 2017; 33: 428–432.
[8] Li FY, Zhu H, Zheng FY. Clinical analysis of pelvic lymphocyst after radical hysterectomy for 121 cases with cervical cancer. Journal of Chinese Oncology. 2019; 25: 75–77. (In Chinese)
[9] Hai-bo Zhang, Xi-wa Zhao, Wei Zhao, Shan Kang. Comparison of laparoscopic high-frequency electrotome and ultrasonic scalpel in cervical cancer surgey. The Chinese Journal of Practical Gynecology and Obstetrics. 2017; 33: 390–394.
[10] Kim YH, Shin HJ, Ju W, Kim SC. Prevention of lymphocele by using gelatin-thrombin matrix as a tissue sealant after pelvic lymphadenectomy in patients with gynecologic cancers: a prospective randomized controlled study. Journal of Gynecologic Oncology. 2017; 28: e37.
[11] Charoenkwan K, Kietpeerakool C. Retroperitoneal drainage versus no drainage after pelvic lymphadenectomy for the prevention of lymphocyst formation in women with gynaecological malignancies. The Cochrane Database of Systematic Reviews. 2017; 29: CD007387.
[12] Nana Gao, Jinwen Jiao, Huijun Chu, Ran Zhang, Liming Wang. Effect of octreotide on lymphatic exudation and lymphocyst formation after operation of female pelvic malignant tumor. Shandong Medicine. 2018; 58: 66–68. (In Chinese)
[13] Benito V, Romeu S, Esparza M, Carballo S, Arencibia O, Medina N, et al. Safety and feasibility analysis of laparoscopic lymphadenectomy in pelvic gynecologic malignancies: a prospective study. International Journal of Gynecologic Cancer. 2015; 25: 1704–1710.
[14] Fujiwara K, Kigawa J, Hasegawa K, Nishimura R, Umezaki N, Ando M, et al. Effect of simple omentoplasty and omentopexy in the prevention of complications after pelvic lymphadenectomy. International Journal of Gynecologic Cancer. 2003; 13: 61–66.
[15] Xie Jinlin, Chen Nanhui. Research progress of lymphatic leakage and lymphoid cyst after pelvic lymph node dissection. Chinese Journal of Urology. 2021; 42: 237–240. (In Chinese)
Top