Decreasing Lymphoid Fluid Accumulation during Lymph-Node Dissection

Abstract

Objective: Retroperitoneal lymphadenectomy is a major component of surgical staging for gynecologic malignancies. In addition to controversy surrounding therapeutic value, substantial morbidity has been associated with the procedure. Postoperative lymphatic leakage due to injury to the lymphatic channels is a common complication and can cause severe morbidity, decrease quality of life, and delay subsequent treatment. To minimize or avoid this complication, it is crucial to understand the risk factors and strategies for prevention. This review focuses on possible risk factors and prevention practices to reduce lymphatic leakage and the incidence of lymphocele formation. Materials and Methods: A literature search was performed in PubMed, Medline,® and Science Direct. Fifty-eight published English-language articles were obtained. Results: Studies on risk factors have produced widely divergent results. The use of biologic glue is strongly associated with a reduction in lymphatic drainage. Both biologic glue and new energy sources can decrease the incidence of lymphocele, but there is no effect of new devices on the incidence of lymphocele requiring treatment. Conclusions: This review suggests that biologic glue and a new energy device are promising, but more studies are needed. © Copyright 2019, Mary Ann Liebert, Inc., publishers 2019.