Lymphatic cysts resulting extended surgical treatment for uterine and cervical cancer

Аннотация

Objective: The study analyzes the incidence and management of postoperative lymphatic cysts.

Полный текст

Methods: The information about 544 cervical cancer patients and 549 patients with uterine cancer who underwent advanced surgical treatment in the department of gynecological oncology of Petrov institute was included.

Results: Outstanding place in the structure of surgical complications hold lymphatic retroperitoneal cysts - 126 cases (11,5%). The patients with locally advanced disease (T2 vs Tl), metastatic involvement of the pelvic lymphatic nodes and patient after preoperative radiation are at the great risk of the development of this complication. Its rate was increased in 5 times after dissection of Pirogov - Rosenmuller — Kloke node. In patients with no involvement of pelvic regional lymphatic nodes the refusal to remove it significantly decrease the incidence of this complication.

Conclusion: The best way of prevention of cyst development was vacuum retroperitoneal draining and leaving “peritoneal frames” (at the absence of the signs of infection and good hemostatic control). The sonography of the pelvis on day 7-9 after extended surgery is strictly indicated to exclude this complication. Conservative treatment of lymphatic cysts was effective in 71,4% of the cases. The large dimensions of the cysts (more than 8 cm in diameter) need to be treated surgically.