A RANDOMIZED STUDY COMPARING RETROPERITONEAL DRAINAGE WITH NO DRAINAGE AFTER LYMPHADENECTOMY IN GYNECOLOGIC MALIGNANCIES

Objective: To evaluate the clinical effectiveness of retroperitoneal d rainage following lymphadenectomy in gynecologic surgery. Methods: One hundred thirty-seven consecutive patients undergoing systematic lymph adenectomy for gynecologic malignancies were randomized to receive (Gr oup A, 68) or not (Group B, 69) retroperitoneal drainage. The pelvic p eritoneum and the paracolic gutters were not sutured after node dissec tion. Perioperative data and complications were recorded. Results: Cli nical and surgical parameters were comparable in the two groups. Posto perative hospital stay was significantly shorter in Group B (P < 0.001 ), whereas the complication rate was significantly higher in Group A ( P = 0.01). This was mainly due to a significant increase in lymphocyst and lymphocyst-related morbidity. Sonographic monitoring for lymphocy st showed free abdominal fluid in 18% of drained and 36% of not-draine d patients (P = 0.03). Symptomatic ascites developed in 2 drained (3%) and 3 not-drained (4%) patients (NS), respectively. Conclusions: Prop hylactic drainage of the retroperitoneum seems to increase lymphadenec tomy-related morbidity and postoperative stay. Therefore, routine drai nage following lymphadenectomy seems to be no longer indicated when th e retroperitoneum is left open. (C) 1997 Academic Press.