Prevention of lymphocele development in gynecologic cancers by the electrothermal bipolar vessel sealing device

Abstract

ObjectiveA number of new techniques have been developed to prevent lymphocele formation after pelvic lymphadenectomy in gynecologic cancers. We assessed whether the electrothermal bipolar vessel sealing device (EBVSD) could decrease the incidence of postoperative lymphocele secondary to pelvic lymphadenectomy.MethodsA total of 321 patients with gynecologic cancer underwent pelvic lymphadenectomy from 2005 to 2011. Pelvic lymphadenectomy without EBVSD was performed in 134 patients, and pelvic lymphadenectomy with EBVSD was performed in 187 patients. We retrospectively compared the incidence of lymphocele and symptoms between both groups.ResultsFour to 8 weeks after operation, 108 cases of lymphocele (34%) were detected by computed tomography scan examination. The incidence of lymphocele after pelvic lymphadenectomy was 56% (75/134) in the tie ligation group, and 18% (33/187) in the EBVSD group. We found a statistically significant difference in the incidence of lymphocele between both groups (p<0.01). To detect the independent risk factor for lymphocele development, we performed multivariate analysis with logistic regression for three variables (device, number of dissected lymph nodes, and operation time). Among these variables, we found a significant difference (p<0.001) for only one device.ConclusionUse of the EBVSD during gynecological cancer operation is useful for preventing the development of lymphocele secondary to pelvic lymphadenectomy.

Incidence of and risk factors for lymphocele formation after lateral pelvic lymph node dissection for rectal cancer: a retrospective study

“…Several surgical techniques and procedures have been reported for the prevention of lymphocele formation. For example, Tsuda et al [37] reported that the use of electrothermal bipolar vessel-sealing devices could reduce the risk of lymphocele formation after gynaecological surgery. Gallotta et al [38] demonstrated that the use of clip applicators was beneficial for preventing lymphocele formation.…”

Use of TachoSil® to Prevent Symptomatic Lymphocele after an Aggressive Tumor Debulking with Lymphadenectomy for Advanced Stage Ovarian Cancer. A Pilot Study

“…Several successful attempts to reduce pelvic lymphocele in women with gynecological cancer by using novel vessels sealing devices, such as Ligasure® [13], Ultracisions® [14] or Ligaclip [9] have been described in the literature. In addition, TachoSil® has also been proposed as a possible strategy to prevent postoperative lymphocele [15,16,17].…”

Predictive Factors of Deep Vein Thrombosis in Gynecologic Cancer Survivors with Lower Extremity Edema: A Single-Center and Retrospective Study

“…But it is often accompanied by complications, such as hemorrhage, hematoma, and lymphocele [52,53]. Of these, lymphocele is one of the most common postoperative complications in that it leads to the occurrence of VTE by venous compression [54,55]. According to a review of the literature, VTE occurred after lymphadectomy at an estimated incidence of 0.8-25% [56][57][58].…”