Evaluating the importance of routine drainage following laparoscopic pelvic lymph node dissection for gynecological malignancies

Kensuke Sakai, Masaru Nakamura, Wataru Yamagami, Tatsuyuki Chiyoda, Yusuke Kobayashi, Hiroshi Nishio, Shigenori Hayashi, Hiroyuki Nomura, Fumio Kataoka, Eiichiro Tominaga, Kouji Banno, Daisuke Aoki

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To determine the efficacy of drainage following pelvic lymph node (PLN) dissection, especially for cases involving laparoscopic surgery. Methods: In this retrospective study, 368 patients with malignant gynecological tumors who underwent systemic PLN dissection at Keio University Hospital between January 2012 and October 2018 were enrolled. Drainage tubes were placed in the retroperitoneal fossa in all patients. Medical records were used for data collection. Results: Laparoscopy was performed on 81 patients, and laparotomy was performed on 287 patients. In the laparoscopy group, tubes were removed 1 day post surgery. In the laparotomy group, tubes were removed 1 day post surgery in 167 patients and 4 days post surgery in 120 patients. Compared with the laparotomy group, we determined the laparoscopy group to have a significantly lower prevalence of lymphocyst (6.2% vs 20.2%, p = 0.002) but a similar prevalence of lymphedema (4.9% vs 5.2%), and symptomatic lymphocyst (2.5% vs 4.5%). The two laparotomy groups did not differ significantly with respect to the prevalence of lymphedema (4.8% vs 5.8%), lymphocyst (20.4% vs 20.0%), or symptomatic lymphocyst (4.2% vs 5.0%). Conclusion: Our results suggest that routine drainage should be omitted, especially in cases involving laparoscopic surgery.

Original languageEnglish
JournalInternational Journal of Gynecology and Obstetrics
DOIs
Publication statusAccepted/In press - 2020

All Science Journal Classification (ASJC) codes

  • Obstetrics and Gynaecology

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