Lymphedema and Lymphocysts Following Lymphadenectomy May Be Prevented by Omentoplasty: A Pilot Study
Identifieur interne : 00AD93 ( Main/Exploration ); précédent : 00AD92; suivant : 00AD94Lymphedema and Lymphocysts Following Lymphadenectomy May Be Prevented by Omentoplasty: A Pilot Study
Auteurs : A. Logmans [Pays-Bas] ; R. H. Kruyt [Pays-Bas] ; H. G. De Bruin [Pays-Bas] ; P. H. Cox [Pays-Bas] ; M. Pillay [Pays-Bas] ; J. B. Trimbos [Pays-Bas]Source :
- Gynecologic Oncology [ 0090-8258 ] ; 1999.
Descripteurs français
- KwdFr :
- MESH :
- effets indésirables : Lymphadénectomie.
- Adulte, Adulte d'âge moyen, Complications postopératoires, Femelle, Humains, Kystes, Lymphoedème, Maladies lymphatiques, Omentum, Projets pilotes, Tumeurs du col de l'utérus.
- Pascal (Inist)
- Wicri :
- topic : Homme.
English descriptors
- KwdEn :
- Adult, Carcinoma, Complication, Cyst, Cysts (prevention & control), Female, Human, Humans, Lymph Node Excision (adverse effects), Lymphadenectomy, Lymphatic Diseases (prevention & control), Lymphedema, Lymphedema (prevention & control), Middle Aged, Nuclear magnetic resonance imaging, Omentum, Omentum (surgery), Pelvic ganglion, Pilot Projects, Plasty, Postoperative Complications (prevention & control), Prevention, Treatment, Treatment efficiency, Uterine Cervical Neoplasms (surgery), Uterine cervix, lymph node dissection, lymphedema, magnetic resonance imaging, omentoplasty.
- MESH :
- adverse effects : Lymph Node Excision.
- prevention & control : Cysts, Lymphatic Diseases, Lymphedema, Postoperative Complications.
- surgery : Omentum, Uterine Cervical Neoplasms.
- Adult, Female, Humans, Middle Aged, Pilot Projects.
Abstract
Objectives. Pelvic lymph node dissection as part of the staging surgery for cervical carcinoma interrupts the afferent lymphatics, so the lymph drains retroperitoneally. New surgical techniques designed to leave the peritoneum open after the retroperitoneal dissection, in particular the application of a pedicled omentoplasty along the dissection route, have been advocated to prevent the formation of lymphocysts and lymphedema. We investigated the possible benefit of pedicled omentoplasty in preventing lymphocysts and lymphedema following pelvic lymph node dissection. Methods. In this pilot study with historical controls we compared the formation of lymphocysts and lymphedema following two different surgical techniques for pelvic node dissection: group I (historical controls), in which the dorsal peritoneum was left open, and group II, in which the dorsal peritoneum was left open with application of a pedicled omentoplasty. In these two groups of gynecologic patients, we compared the lymph flow patterns and the occurrence of lymphedema following systemic pelvic lymphadenectomy. The two groups were of comparable clinical status and consisted of 12 (group I) and 10 (group II) patients. Lymphocysts, if any, were detected by CT scan, the lymph flow patterns were visualized by dynamic lymphscintography, and lymphedema was visualized by physical examination and magnetic resonance imaging of the groin and the upper leg. Results. In both groups a distinct intraperitoneal absorption of the lymph fluid was observed. Pedicled omentoplasty seemed to facilitate the absorption or transport of lymph fluid, resulting in less lymphedema in the upper leg. Conclusion. It appeared that leaving the dorsal peritoneum open to give the lymph stream the opportunity to pour into the abdominal cavity is important in preventing lymphocysts and lymphedema. The dynamic lymphscintigraphy described in this paper showed that the intraabdominal lymph flow is absorbed by the peritoneum and even more quickly by the pedicled omentum.
Url:
DOI: 10.1006/gyno.1999.5624
Affiliations:
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<term>Carcinoma</term>
<term>Complication</term>
<term>Cyst</term>
<term>Cysts (prevention & control)</term>
<term>Female</term>
<term>Human</term>
<term>Humans</term>
<term>Lymph Node Excision (adverse effects)</term>
<term>Lymphadenectomy</term>
<term>Lymphatic Diseases (prevention & control)</term>
<term>Lymphedema</term>
<term>Lymphedema (prevention & control)</term>
<term>Middle Aged</term>
<term>Nuclear magnetic resonance imaging</term>
<term>Omentum</term>
<term>Omentum (surgery)</term>
<term>Pelvic ganglion</term>
<term>Pilot Projects</term>
<term>Plasty</term>
<term>Postoperative Complications (prevention & control)</term>
<term>Prevention</term>
<term>Treatment</term>
<term>Treatment efficiency</term>
<term>Uterine Cervical Neoplasms (surgery)</term>
<term>Uterine cervix</term>
<term>lymph node dissection</term>
<term>lymphedema</term>
<term>magnetic resonance imaging</term>
<term>omentoplasty</term>
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<term>Adulte d'âge moyen</term>
<term>Complications postopératoires ()</term>
<term>Femelle</term>
<term>Humains</term>
<term>Kystes ()</term>
<term>Lymphadénectomie (effets indésirables)</term>
<term>Lymphoedème ()</term>
<term>Maladies lymphatiques ()</term>
<term>Omentum ()</term>
<term>Projets pilotes</term>
<term>Tumeurs du col de l'utérus ()</term>
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<term>Lymphatic Diseases</term>
<term>Lymphedema</term>
<term>Postoperative Complications</term>
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<keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Omentum</term>
<term>Uterine Cervical Neoplasms</term>
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<term>Adulte d'âge moyen</term>
<term>Complications postopératoires</term>
<term>Femelle</term>
<term>Humains</term>
<term>Kystes</term>
<term>Lymphoedème</term>
<term>Maladies lymphatiques</term>
<term>Omentum</term>
<term>Projets pilotes</term>
<term>Tumeurs du col de l'utérus</term>
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<term>Col utérus</term>
<term>Complication</term>
<term>Efficacité traitement</term>
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<term>Femelle</term>
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<front><div type="abstract" xml:lang="en">Objectives. Pelvic lymph node dissection as part of the staging surgery for cervical carcinoma interrupts the afferent lymphatics, so the lymph drains retroperitoneally. New surgical techniques designed to leave the peritoneum open after the retroperitoneal dissection, in particular the application of a pedicled omentoplasty along the dissection route, have been advocated to prevent the formation of lymphocysts and lymphedema. We investigated the possible benefit of pedicled omentoplasty in preventing lymphocysts and lymphedema following pelvic lymph node dissection. Methods. In this pilot study with historical controls we compared the formation of lymphocysts and lymphedema following two different surgical techniques for pelvic node dissection: group I (historical controls), in which the dorsal peritoneum was left open, and group II, in which the dorsal peritoneum was left open with application of a pedicled omentoplasty. In these two groups of gynecologic patients, we compared the lymph flow patterns and the occurrence of lymphedema following systemic pelvic lymphadenectomy. The two groups were of comparable clinical status and consisted of 12 (group I) and 10 (group II) patients. Lymphocysts, if any, were detected by CT scan, the lymph flow patterns were visualized by dynamic lymphscintography, and lymphedema was visualized by physical examination and magnetic resonance imaging of the groin and the upper leg. Results. In both groups a distinct intraperitoneal absorption of the lymph fluid was observed. Pedicled omentoplasty seemed to facilitate the absorption or transport of lymph fluid, resulting in less lymphedema in the upper leg. Conclusion. It appeared that leaving the dorsal peritoneum open to give the lymph stream the opportunity to pour into the abdominal cavity is important in preventing lymphocysts and lymphedema. The dynamic lymphscintigraphy described in this paper showed that the intraabdominal lymph flow is absorbed by the peritoneum and even more quickly by the pedicled omentum.</div>
</front>
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<name sortKey="Trimbos, J B" sort="Trimbos, J B" uniqKey="Trimbos J" first="J. B." last="Trimbos">J. B. Trimbos</name>
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