Prospective Randomized Study to Compare Lymphocele and Lymphorrhea Control Following Inguinal and Axillary Therapeutic Lymph Node Dissection With or Without the Use of an Ultrasonic Scalpel.
Identifieur interne : 000697 ( PubMed/Checkpoint ); précédent : 000696; suivant : 000698Prospective Randomized Study to Compare Lymphocele and Lymphorrhea Control Following Inguinal and Axillary Therapeutic Lymph Node Dissection With or Without the Use of an Ultrasonic Scalpel.
Auteurs : Marie-Laure Matthey-Gié [Suisse] ; Olivier Gié [Suisse] ; Sona Deretti [Suisse] ; Nicolas Demartines [Suisse] ; Maurice Matter [Suisse]Source :
- Annals of surgical oncology [ 1534-4681 ] ; 2016.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen, Aisselle, Canal inguinal (), Canal inguinal (anatomopathologie), Femelle, Humains, Lymphadénectomie, Lymphocèle (), Maladies lymphatiques (), Mâle, Pronostic, Science des ultrasons, Stade de la tumeur, Tumeurs (), Tumeurs (anatomopathologie), Vaisseaux lymphatiques (), Vaisseaux lymphatiques (anatomopathologie), Vaisseaux lymphatiques (traumatismes), Études de suivi, Études prospectives.
- MESH :
- anatomopathologie : Canal inguinal, Tumeurs, Vaisseaux lymphatiques.
- traumatismes : Vaisseaux lymphatiques.
- Adulte d'âge moyen, Aisselle, Canal inguinal, Femelle, Humains, Lymphadénectomie, Lymphocèle, Maladies lymphatiques, Mâle, Pronostic, Science des ultrasons, Stade de la tumeur, Tumeurs, Vaisseaux lymphatiques, Études de suivi, Études prospectives.
English descriptors
- KwdEn :
- Axilla, Female, Follow-Up Studies, Humans, Inguinal Canal (pathology), Inguinal Canal (surgery), Lymph Node Excision, Lymphatic Diseases (prevention & control), Lymphatic Vessels (injuries), Lymphatic Vessels (pathology), Lymphatic Vessels (surgery), Lymphocele (prevention & control), Male, Middle Aged, Neoplasm Staging, Neoplasms (pathology), Neoplasms (surgery), Prognosis, Prospective Studies, Ultrasonics.
- MESH :
- injuries : Lymphatic Vessels.
- pathology : Inguinal Canal, Lymphatic Vessels, Neoplasms.
- prevention & control : Lymphatic Diseases, Lymphocele.
- surgery : Inguinal Canal, Lymphatic Vessels, Neoplasms.
- Axilla, Female, Follow-Up Studies, Humans, Lymph Node Excision, Male, Middle Aged, Neoplasm Staging, Prognosis, Prospective Studies, Ultrasonics.
Abstract
Many attempts to prevent lymphatic complications following therapeutic lymph node dissection (TLND) have included modifications in surgical techniques through the use of ultrasonic scalpels (USS) or lymphostatic agents. Previous randomized studies that enrolled heterogeneous groups of patients attempted to confirm the efficacy of such techniques. The aim of the present study was to evaluate the efficacy of the USS following TLND.
DOI: 10.1245/s10434-015-5025-y
PubMed: 26714939
Affiliations:
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Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Visceral Surgery, Centre Hospitalier Universitaire Vaudois, CHUV, University Hospital of Lausanne, Lausanne</wicri:regionArea><placeName><settlement type="city">Lausanne</settlement><region nuts="3" type="region">Canton de Vaud</region></placeName></affiliation></author><author><name sortKey="Gie, Olivier" sort="Gie, Olivier" uniqKey="Gie O" first="Olivier" last="Gié">Olivier Gié</name><affiliation wicri:level="3"><nlm:affiliation>Department of Visceral Surgery, Centre Hospitalier Universitaire Vaudois, CHUV, University Hospital of Lausanne, Lausanne, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Visceral Surgery, Centre Hospitalier Universitaire Vaudois, CHUV, University Hospital of Lausanne, Lausanne</wicri:regionArea><placeName><settlement type="city">Lausanne</settlement><region nuts="3" type="region">Canton de Vaud</region></placeName></affiliation></author><author><name sortKey="Deretti, Sona" sort="Deretti, Sona" uniqKey="Deretti S" first="Sona" last="Deretti">Sona Deretti</name><affiliation wicri:level="3"><nlm:affiliation>Department of Visceral Surgery, Centre Hospitalier Universitaire Vaudois, CHUV, University Hospital of Lausanne, Lausanne, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Visceral Surgery, Centre Hospitalier Universitaire Vaudois, CHUV, University Hospital of Lausanne, Lausanne</wicri:regionArea><placeName><settlement type="city">Lausanne</settlement><region nuts="3" type="region">Canton de Vaud</region></placeName></affiliation></author><author><name sortKey="Demartines, Nicolas" sort="Demartines, Nicolas" uniqKey="Demartines N" first="Nicolas" last="Demartines">Nicolas Demartines</name><affiliation wicri:level="3"><nlm:affiliation>Department of Visceral Surgery, Centre Hospitalier Universitaire Vaudois, CHUV, University Hospital of Lausanne, Lausanne, Switzerland. demartines@chuv.ch.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Visceral Surgery, Centre Hospitalier Universitaire Vaudois, CHUV, University Hospital of Lausanne, Lausanne</wicri:regionArea><placeName><settlement type="city">Lausanne</settlement><region nuts="3" type="region">Canton de Vaud</region></placeName></affiliation></author><author><name sortKey="Matter, Maurice" sort="Matter, Maurice" uniqKey="Matter M" first="Maurice" last="Matter">Maurice Matter</name><affiliation wicri:level="3"><nlm:affiliation>Department of Visceral Surgery, Centre Hospitalier Universitaire Vaudois, CHUV, University Hospital of Lausanne, Lausanne, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Visceral Surgery, Centre Hospitalier Universitaire Vaudois, CHUV, University Hospital of Lausanne, Lausanne</wicri:regionArea><placeName><settlement type="city">Lausanne</settlement><region nuts="3" type="region">Canton de Vaud</region></placeName></affiliation></author></analytic><series><title level="j">Annals of surgical oncology</title><idno type="eISSN">1534-4681</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Axilla</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Inguinal Canal (pathology)</term><term>Inguinal Canal (surgery)</term><term>Lymph Node Excision</term><term>Lymphatic Diseases (prevention & control)</term><term>Lymphatic Vessels (injuries)</term><term>Lymphatic Vessels (pathology)</term><term>Lymphatic Vessels (surgery)</term><term>Lymphocele (prevention & control)</term><term>Male</term><term>Middle Aged</term><term>Neoplasm Staging</term><term>Neoplasms (pathology)</term><term>Neoplasms (surgery)</term><term>Prognosis</term><term>Prospective Studies</term><term>Ultrasonics</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Aisselle</term><term>Canal inguinal ()</term><term>Canal inguinal (anatomopathologie)</term><term>Femelle</term><term>Humains</term><term>Lymphadénectomie</term><term>Lymphocèle ()</term><term>Maladies lymphatiques ()</term><term>Mâle</term><term>Pronostic</term><term>Science des ultrasons</term><term>Stade de la tumeur</term><term>Tumeurs ()</term><term>Tumeurs (anatomopathologie)</term><term>Vaisseaux lymphatiques ()</term><term>Vaisseaux lymphatiques (anatomopathologie)</term><term>Vaisseaux lymphatiques (traumatismes)</term><term>Études de suivi</term><term>Études prospectives</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Canal inguinal</term><term>Tumeurs</term><term>Vaisseaux lymphatiques</term></keywords><keywords scheme="MESH" qualifier="injuries" xml:lang="en"><term>Lymphatic Vessels</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Inguinal Canal</term><term>Lymphatic Vessels</term><term>Neoplasms</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Lymphatic Diseases</term><term>Lymphocele</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Inguinal Canal</term><term>Lymphatic Vessels</term><term>Neoplasms</term></keywords><keywords scheme="MESH" qualifier="traumatismes" xml:lang="fr"><term>Vaisseaux lymphatiques</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Axilla</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Lymph Node Excision</term><term>Male</term><term>Middle Aged</term><term>Neoplasm Staging</term><term>Prognosis</term><term>Prospective Studies</term><term>Ultrasonics</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Aisselle</term><term>Canal inguinal</term><term>Femelle</term><term>Humains</term><term>Lymphadénectomie</term><term>Lymphocèle</term><term>Maladies lymphatiques</term><term>Mâle</term><term>Pronostic</term><term>Science des ultrasons</term><term>Stade de la tumeur</term><term>Tumeurs</term><term>Vaisseaux lymphatiques</term><term>Études de suivi</term><term>Études prospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Many attempts to prevent lymphatic complications following therapeutic lymph node dissection (TLND) have included modifications in surgical techniques through the use of ultrasonic scalpels (USS) or lymphostatic agents. Previous randomized studies that enrolled heterogeneous groups of patients attempted to confirm the efficacy of such techniques. The aim of the present study was to evaluate the efficacy of the USS following TLND.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">26714939</PMID><DateCreated><Year>2016</Year><Month>03</Month><Day>31</Day></DateCreated><DateCompleted><Year>2016</Year><Month>12</Month><Day>20</Day></DateCompleted><DateRevised><Year>2016</Year><Month>12</Month><Day>30</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1534-4681</ISSN><JournalIssue CitedMedium="Internet"><Volume>23</Volume><Issue>5</Issue><PubDate><Year>2016</Year><Month>May</Month></PubDate></JournalIssue><Title>Annals of surgical oncology</Title><ISOAbbreviation>Ann. Surg. Oncol.</ISOAbbreviation></Journal><ArticleTitle>Prospective Randomized Study to Compare Lymphocele and Lymphorrhea Control Following Inguinal and Axillary Therapeutic Lymph Node Dissection With or Without the Use of an Ultrasonic Scalpel.</ArticleTitle><Pagination><MedlinePgn>1716-20</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1245/s10434-015-5025-y</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Many attempts to prevent lymphatic complications following therapeutic lymph node dissection (TLND) have included modifications in surgical techniques through the use of ultrasonic scalpels (USS) or lymphostatic agents. Previous randomized studies that enrolled heterogeneous groups of patients attempted to confirm the efficacy of such techniques. The aim of the present study was to evaluate the efficacy of the USS following TLND.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">Between 2009 and 2013, patients undergoing inguinal or axillary TLND or completion lymph node dissection after positive sentinel lymph node biopsy for melanoma, squamous cell carcinoma or sarcoma were randomized into two surgical dissection technique groups. In the USS dissection arm, surgery was conducted using a USS. These were compared with a control group whereby ligation and monopolar electrocautery was utilized. For axillary dissection, a standardized level III lymphadenectomy was performed. A complete inguinal lymphadenectomy including Cloquet's node was performed, and at the end of the procedure a Redon suction drain was routinely placed in the axilla and groin. The primary endpoint was to compare the time to drain removal in both groups, while the secondary endpoint was to evaluate the rate of complications (infection, fistula, lymphocele formation, wound dehiscence, lymphedema) between the two groups.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">A total of 80 patients were enrolled in this trial; 40 patients were randomly assigned to both the USS group and the control (C) group. No significant differences were observed in terms of duration of drainage (USS: 31 ± 20 vs. C: 32 ± 18; p = 0.83); however, a significantly increased rate of lymphedema (defined as an increased circumference of the operated limb of more than 10 %) was identified in the USS group (USS: 50 % vs. C: 27.5 %; p = 0.04). No other significant differences were recorded for postoperative complications, including surgical site infection (USS: 5 % vs. C: 7.5 %; p = 0.68), lymphatic fistula (USS: 5 % vs. C: 2.5 %; p = 0.62), lymphocele (USS: 32.5 % vs. C: 22.5 %; p = 0.33), and hematoma (USS: 5 % vs. C: 2.5 %; p = 0.62).</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">The use of USS failed to offer any significant reduction in length of drain usage and operative complication, but it seems to increase the rate of lymphedema formation.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Matthey-Gié</LastName><ForeName>Marie-Laure</ForeName><Initials>ML</Initials><AffiliationInfo><Affiliation>Department of Visceral Surgery, Centre Hospitalier Universitaire Vaudois, CHUV, University Hospital of Lausanne, Lausanne, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gié</LastName><ForeName>Olivier</ForeName><Initials>O</Initials><AffiliationInfo><Affiliation>Department of Visceral Surgery, Centre Hospitalier Universitaire Vaudois, CHUV, University Hospital of Lausanne, Lausanne, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Deretti</LastName><ForeName>Sona</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Visceral Surgery, Centre Hospitalier Universitaire Vaudois, CHUV, University Hospital of Lausanne, Lausanne, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Demartines</LastName><ForeName>Nicolas</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Department of Visceral Surgery, Centre Hospitalier Universitaire Vaudois, CHUV, University Hospital of Lausanne, Lausanne, Switzerland. demartines@chuv.ch.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Matter</LastName><ForeName>Maurice</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Visceral Surgery, Centre Hospitalier Universitaire Vaudois, CHUV, University Hospital of Lausanne, Lausanne, Switzerland.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D003160">Comparative Study</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016449">Randomized Controlled Trial</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2015</Year><Month>12</Month><Day>29</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Ann Surg Oncol</MedlineTA><NlmUniqueID>9420840</NlmUniqueID><ISSNLinking>1068-9265</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D001365" MajorTopicYN="N">Axilla</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005500" MajorTopicYN="N">Follow-Up Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007264" MajorTopicYN="N">Inguinal Canal</DescriptorName><QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName><QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008197" MajorTopicYN="N">Lymph Node Excision</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008206" MajorTopicYN="N">Lymphatic Diseases</DescriptorName><QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D042601" MajorTopicYN="N">Lymphatic Vessels</DescriptorName><QualifierName UI="Q000293" MajorTopicYN="N">injuries</QualifierName><QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName><QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008210" MajorTopicYN="N">Lymphocele</DescriptorName><QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009367" MajorTopicYN="N">Neoplasm Staging</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009369" MajorTopicYN="N">Neoplasms</DescriptorName><QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName><QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011379" MajorTopicYN="N">Prognosis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011446" MajorTopicYN="N">Prospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014465" MajorTopicYN="Y">Ultrasonics</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2015</Year><Month>08</Month><Day>04</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2015</Year><Month>12</Month><Day>31</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2015</Year><Month>12</Month><Day>31</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2016</Year><Month>12</Month><Day>21</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">26714939</ArticleId><ArticleId IdType="doi">10.1245/s10434-015-5025-y</ArticleId><ArticleId IdType="pii">10.1245/s10434-015-5025-y</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Suisse</li></country><region><li>Canton de Vaud</li></region><settlement><li>Lausanne</li></settlement></list><tree><country name="Suisse"><region name="Canton de Vaud"><name sortKey="Matthey Gie, Marie Laure" sort="Matthey Gie, Marie Laure" uniqKey="Matthey Gie M" first="Marie-Laure" last="Matthey-Gié">Marie-Laure Matthey-Gié</name></region><name sortKey="Demartines, Nicolas" sort="Demartines, Nicolas" uniqKey="Demartines N" first="Nicolas" last="Demartines">Nicolas Demartines</name><name sortKey="Deretti, Sona" sort="Deretti, Sona" uniqKey="Deretti S" first="Sona" last="Deretti">Sona Deretti</name><name sortKey="Gie, Olivier" sort="Gie, Olivier" uniqKey="Gie O" first="Olivier" last="Gié">Olivier Gié</name><name sortKey="Matter, Maurice" sort="Matter, Maurice" uniqKey="Matter M" first="Maurice" 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