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The effect of peritoneal flap fixation with curling technique on postoperative lymphocele formation in robot-assisted
Ali Serdar Gozen1, Samet Senel2, Antonios Koudonas3
1Department of Urology, Medius-Kliniken, Ostfildern, Germany.
Background:
In robot-assisted radical prostatectomy (RARP), the peritoneal edges isolate the extended pelvic lymph node dissection bed from the peritoneal cavity. We studied the effect of peritoneal re-configuration through peritoneal flap fixation (PFF) with curling technique on lymphocele development.
Method:
We included 2087 patients who underwent RARP between 2010 and 2022. Two hundred and thirty patients whose operation was performed using the PFF with curling technique were matched in a 1:1 ratio with non-PFF patients based on age, body mass index, initial prostate-specific antigen, and number of removed lymph nodes. Demographic, clinical, intraoperative and postoperative characteristics were collected. Complications were classified using the Clavien-Dindo system and the presence of lymphocele was documented.
Results:
The two groups were similar in respect to matching parameters. Fifteen (6.5%) patients in the non-PFF group and two (0.9%) patients in the PFF group suffered from symptomatic lymphocele with symptoms such as abdominal pain, fever, lower extremity and/or genital oedema (p = 0.001). Asymptomatic lymphocele was diagnosed by ultrasonography in 19 (8.3%) patients in the non-PFF group and eight (3.5%) patients in the PFF group (p = 0.029).
Conclusion:
The results of our study support this concept by providing solid indications of the clinical benefits and safety of PFF with the curling technique.
