P. Morice et al., Retroperitoneal drainage after complete paraaortic lymphadenectomy for gynecologic cancer: A randomized trial, OBSTET GYN, 97(2), 2001, pp. 243-247
Objective: To determine the relationship between retroperitoneal drainage a
fter complete para-aortic lymphadenectomy for gynecologic cancer and subseq
uent development of lymphocysts.
Methods: Eighty women undergoing complete para-aortic lymphadenectomy up to
the level of the left renal vein for ovarian (n = 43) or cervical carcinom
a (n = 37) were randomly assigned to receive drainage or no drainage of the
para-aortic area. Most of patients had pelvic drainage. Abdominopelvic ult
rasonography was done 8 to 12 days after surgery. postoperative complicatio
ns, duration of hospital stay, and characteristics of asymptomatic lymphocy
sts were studied.
Results: Forty-two women had para-aortic drainage and 38 did not. Complicat
ions occurred in 15 patients who had drainage and in 5 patients who did not
have drainage (36% versus 13%; P < .02). Three patients (8%) in the undrai
ned group had complications potentially related to drainage (symptomatic ly
mphocysts or ascites) compared with 11 (26%) in the drained group (<chi>(2)
= 4.6; P < .05). Median duration of the hospital stay was 9 days in the un
drained group and 11 days in the drained group (P < .03). The number of asy
mptomatic pars-aortic lymphocysts detected during the ultrasonography was 9
(24%) in the undrained and 2 (5%) in the drained group (chi (2) = 4.6; P <
.05).
Conclusions: The number of asymptomatic para-aortic lymphocysts was higher
in patients who did not undergo drainage, but morbidity and the duration of
hospitalization were increased in these patients. Routine drainage of the
retroperitoneum after pam-aortic lymphadenectomy should be abandoned. (Obst
et Gynecol 2001;97:243-7. (C) 2001 by The American College of Obstetricians
and Gynecologists.).