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The Effect of Nonperitonization and Laparoscopic Lymphadenectomy for Minimizing the Incidence of Lymphocyst Formation After Radical Hysterectomy for Cervical Cancer
  1. Nae Yoon Park, MD,
  2. Won Joon Seong, MD,
  3. Gun Oh Chong, MD,
  4. Dae Gy Hong, MD,
  5. Young Lae Cho, MD,
  6. Il Soo Park, MD and
  7. Yoon Soon Lee, MD
  1. Department of Obstetrics and Gynecology, School of Medicine, Kyungpook National University Hospital, Daegu, Korea.
  1. Address correspondence and reprint requests to Yoon Soon Lee, MD, Kyungpook National University Hospital, 50 Samdok-2Ga, Chung-Gu, Daegu, 700-721, Korea. E-mail: yslee{at}knu.ac.kr.

Abstract

Objectives: To determine the clinical effect of nonperitonization and laparoscopic lymphadenectomy using bipolar electrocautery after radical hysterectomy for cervical cancer compared with peritonization and open lymphadenectomy using monopolar electrocautery.

Materials and Methods: This was a retrospective study of 180 patients who underwent a radical hysterectomy and pelvic lymph node dissection (PLND) for cervical cancer from August 1998 to August 2007. The patients were composed of the Peritonization + Laparotomy group (group A; n = 98, 196 PLND) and the Nonperitonization + Laparoscopy group (group B; n = 82, 164 PLND). Group B left the peritoneum in front of the PLND open. Two closed-suction drains were placed at each side of the PLND.

Results: Group B statistically showed a lesser total amount of lymphatic drainage (P = 0.001), shorter duration of inserted drains (P < 0.001), and shorter length of hospital stay (P < 0.001), compared with group A. The formation of lymphocysts occurred in 30 patients (41 lymphocysts) of group A and 5 patients (5 lymphocysts) of group B. Lymphocyst formation of group B had a statistically lower incidence than that of group A (P < 0.001). Lymphocyst formation was associated with an increase in the total amount of lymphatic drainage in group A (P = 0.090) and group B (P = 0.041) and a pathologic type of adenocarcinoma in group B (P = 0.016). Surgical experiences were not correlated with lymphocyst formation.

Conclusions: The omission of peritonization and laparoscopic lymphadenectomy using bipolar electrocautery in early-stage cervical cancer were more effective than peritonization and open lymphadenectomy using monopolar electrocautery in minimizing the incidence of lymphocyst formation.

  • Cervical cancer
  • Radical hysterectomy
  • Pelvic lymphadenectomy
  • Lymphocyst
  • Nonperitonization

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Footnotes

  • The authors have no commercial, proprietary, or financial interest in the products or companies described in this paper.

  • Conflict of interest statement: The authors declare that there are no conflicts of interest.

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