LYMPHOCYSTS AND COMPLICATIONS AFTER PELVI C PARAAORTAL LYMPHADENECTOMY DEPENDING ON PERITONEAL CLOSURE

From January 1988 to December 1991, 343 women were operated for genita l carcinoma at the 1st Gynaecological Department of the University Mun ich. Additionally to the corresponding cancer operations, pelvic or pe lvic and paraaortic lymphadenectomy was performed. In a postoperative systematic and prospective study with ultrasound, we detected a high i ncidence of 48% of postoperative lymphocysts. Only a few were symptoma tic and even less required therapy. In this study we were especially i nterested in the influence of closure of the pelvic peritoneum on the incidence of lymphocysts. Thus, we inaugurated a prospective study in 1991 with 49 patients with an open peritoneum and compared these resul ts to 294 women who had standard closure of the peritoneum. There was a significantly higher rate of lymphocysts in patients with peritoneal closure (45,2%) in comparison to 20.4% lymphocysts in patients withou t peritoneal closure. In the study group (open peritoneum) 6.1% of the patients with lymphocysts showed symptoms, only 4.1% needed therapy. In the control group (closed peritoneum), 14.6% of the patients with l ymphocysts were symptomatic and 8.2% needed therapy. These differences are not statistically significant. Other complications such as haemor rhage, fever or ileus were comparable in both groups. Our results do n ot supply sufficient proof, that leaving the peritoneum open significa ntly reduces symptomatic lymphocysts.