Management of lymphocysts after cervical carcinoma surgery

In the Gynecological Clinic of the Oncological National Center of Georgia from 1964 to 1999 1,805 extended hysterectomies due to carcinoma of the cervix uteri were performed. Retroperitoneal lymphocysts were revealed in 4.3% of the cases. Of all stage I disease lymphocysts had developed in 2.8% of cases and in stage II 7.2%. Correlations between lymph node metastatic damage 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 women (over 60 years). Unilateral lymphocysts developed more frequently (left-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 25.6% of cases more than 10 cm; 18% of the lymphocysts were asymtomatic and did not need any treatment. High temperature, pain, changes in blood occurring 4-5 days after surgery are indications of parametritis. Lymphocysts usually arise 11-12 days after surgery. Ultrasonography is a highly informative diagnosic method to detect this disease. In 23% of cases, the method of treatment was conservative therapy, 35.8% of patients had punctures, thus micro-drainage was performed and a cocktail injection into the cyst cavity was carried out. In 7.7% of cases lymphocyst resection and drainage was carried out.