Management of lymphocysts after cervical carcinoma surgery

In the Gynecological Clinic of the Oncological National Center of Georgia f rom 1964 to 1999 1,805 extended hysterectomies due to carcinoma of the cerv ix uteri wore performed. Retroperitoneal lymphocysts were revealed in 4.3% of the cases. Of all stage I disease lymphocysts had developed in 2.8% of c ases and in stage II 7.2%. Correlations between lymph node metastatic damag e and development of lymphocysts were not found. The peak incidence (6.2-6. 4%) of lymphocysts appeared to be in women younger than 30 and in elderly w omen (over 60 years). Unilateral lymphocysts developed more frequently (lef t-side in 38.9% in right-side in 33.3%) than bilateral ones (28.3%). In 32. 5% of cases the size was less than 5 cm, in 42.3% of cases 6-10 cm and in 2 5.6% of cases more than 10 cm; 18% of the lymphocysts were asymtomatic and did not need any treatment. High temperature, pain, changes in blood occurr ing 4-5 days after surgery are indications of parametritis. Lymphocysts usu ally arise 11-12 days after surgery. Ultrasonography is a highly informativ e diagnosic method to detect this disease. In 23% of cases, the method of t reatment was concervative therapy, 35.8% of patients had punctures, thus mi cro-drainage was performed and a cocktail injection into the cyst cavity wa s carried out. In 7.7% of cases lymphocyst resection and drainage was carri ed out.