Influence of Body Mass Index, Surgical Approach and Lymphadenectomy on the Development of Symptomatic Lymphoceles after Radical Prostatectomy

被引：17

作者：

Mundhenk, J. ^{[1
]}

Hennenlotter, J. ^{[1
]}

Alloussi, S. ^{[1
]}

Selbherr, D. ^{[1
]}

Martzog, J. C. ^{[1
]}

Todenhoefer, T. ^{[1
]}

Kruck, S. ^{[1
]}

Schwentner, C. ^{[1
]}

Stenzl, A. ^{[1
]}

Schilling, D. ^{[1
]}

机构：

[1] Univ Tubingen, Dept Urol, DE-72076 Tubingen, Germany

来源：

UROLOGIA INTERNATIONALIS | 2013年 / 90卷 / 03期

关键词：

Prostatectomy; Lymphocele; Pelvic lymph node dissection; Body mass index; LYMPH-NODE DISSECTION; EXTENDED PELVIC LYMPHADENECTOMY; RETROPUBIC PROSTATECTOMY; COMPLICATIONS; PREDICTORS; OUTCOMES; YIELD;

D O I：

10.1159/000347043

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Purpose: Identification of factors influencing lymphocele formation requiring intervention after radical prostatectomy. Methods: 302 patients undergoing radical retropubic prostatectomy (RRP, n = 174) or transperitoneal robot-assisted laparoscopic prostatectomy (RALP, n = 128) by the same surgeon were retrospectively reviewed. Incidence of symptomatic lymphoceles (SLC) was compared with clinical and pathological data (contingency analyses, Wilcoxon-Kruskal-Wallis test). Results: Sixteen patients (5.3%) developed SLC. SLC occurred significantly more frequently after RRP compared to RALP (8.0 vs. 0.8%, p = 0.0008). Patients with SLC had more lymph nodes (LN) removed median (17 vs. 13, p = 0.009) and a significantly lower BMI (median 24.4 vs. 26.4, p = 0.0008). Presence of LN metastases (n = 18 patients, 6.0%) showed no statistical impact on SLC. In a multivariate analysis surgical method, the number of resected LN and the BMI remained independent predictors of SLC formation. Conclusions: The lower incidence of SLC after RALP compared to RRP probably results from peritoneal drainage of lymphatic fluid. The correlation of removed LN and SLC might be explained by increased injury of lymphatic vessels during more extended LN dissection. Why patients with lower BMI are more prone to develop SLC still remains unclear. However, early postoperative mobilization in nonobese patients might be a contributing factor. Copyright (C) 2013 S. Karger AG, Basel

引用

页码：270 / 276

页数：7

共 26 条

[1] Intraoperative and perioperative morbidity of contemporary radical retropubic prostatectomy in a consecutive series of 1243 patients: Results of a single center between 1999 and 2002 [J].