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Lymphoceles after pelvic lymph node dissection during robot-assisted radical prostatectomy.
Jonas J L Meenderink1, Lisa J Kroon1,2,3,4, Margaretha A van der Slot2,3
1Department of Urology, Erasmus MC Cancer Institute, Erasmus MC, Rotterdam, The Netherlands.
Translational Andrology and Urology
|December 18, 2023
Summary
Symptomatic lymphoceles (SLC) occur in 7.4% of patients after prostatectomy surgery. Increased body mass index (BMI) is a key predictor, with over half of patients requiring drainage.
Area of Science:
- Urology
- Surgical Oncology
- Medical Imaging
Background:
- Lymphoceles are common after pelvic lymph node dissection (PLND) during robot-assisted radical prostatectomy (RARP).
- Symptomatic lymphoceles (SLC) present a significant post-operative complication.
- Investigating incidence and predictors of SLC is crucial for patient management.
Purpose of the Study:
- To determine the incidence of imaging-confirmed symptomatic lymphoceles (SLC) post-RARP with PLND.
- To identify predictive factors associated with SLC development.
- To assess treatment strategies for SLC.
Main Methods:
- Retrospective analysis of 404 patients undergoing RARP with PLND.
- Comparison of patient characteristics and pathological data between those with and without SLC.
- Multivariable analysis to identify independent predictors of SLC.
Main Results:
- An incidence of 7.4% for symptomatic lymphoceles (SLC) was observed.
- The median time to SLC presentation was 12 weeks, with 33% occurring after 180 days.
- Elevated body mass index (BMI) was the sole significant predictor for SLC (OR=1.7, P=0.04).
Conclusions:
- Symptomatic lymphoceles (SLC) frequently require intervention, with over 50% needing percutaneous drainage.
- Delayed presentation of SLCs can extend beyond centralized follow-up periods.
- Increased BMI is a significant risk factor for developing symptomatic lymphoceles after RARP with PLND.
