Prevention And Treatment Of Pelvic Lymphocyst After Pelvic Lymphnodes Dissection

Background and ObjectivePelvic lymphocele is one of postoperative complications after pelvic lymphnodes dissection. Damage to the lymphatic system is the mechanism of pelvic lymphocele.Small lymphocele can be absorbed by surrounding tissue, big lymphoceles can lead to morbidity by causing obstructive or infectious complications or even lead to death. Lymphocele related symptoms are due to compression of adjacent anatomic structures. Lymphoceles can cause hydronephrosis by compression of ureters,constipation by rectosigmoid compression,lower extremity edema by venous compression, pain by compression of pelvic nerves and urinary frequency by bladder compression.Lymphoceles serious influence the quality of life of the patients. Intraoperative common preventive measures include ligation lymphatic, placed drainage tube, omentoplasty and omentopexy, nonclosure of peritoneum and placed fibrin glue. Because of intraoperative distinguish difficulties, we need to seek an effective way to reduce leakage of lymph and prevent lymphoceles formation.Ultrasound scalpel and BiCamp are widely used in surgery now, a plenty of domestic and foreign literature reports confirm, that these two kinds of electronic instruments can effectively reduce peri-operative bleeding and surgical time.This study aim to investigate the value of Ultrasonic scalpel and BiCamp in pelvic lymphadenectomy. Materials and MethodsAmong 248 cases who received abdominal pelvic lymphadenectomy in our hospital from Jan 2009 to Feb 2011,143 readmission patients were included in experiment standard, and the average age of the patients was 47.6±9.7 years old.All patients were pleaced the negative pressure drainage tubes out of the vaginal residual in pelvic retroperitoneal retroperitoneal and closed the pelvic retroperitoneal.43 cases were performed using ultrasonic scalpel or BiCamp to clean the lymph nodes and the other 100 cases were performed without using ultrasonic scalpel or BiCamp. The operative time, interoperative blood loss, the number of lymph nodes, pelvic drainage, postoperative urination recovery time, urinary retention, deep vein thrombosis (DVT) and hospital days were compared between two groups. Student'S t, chi-square and Fisher'S tests were performed for statistical analysis of the results.Results1. Comparison of the treatment group and the control group in operation and after operation.The operative time was shorter, the interoperative blood loss was less and drainage fluid volume was less in the treatment group with ultrasonic scalpel and BiCamp.The difference between the two groups was statistically signifcant (P<0.05).2. Postoperative urination recovery time, urinary retention, deep vein thrombosis (DVT) and hospital stays, the difference between the two groups was statistically non-significance (P>0.05).3. Compare with the treatment group,the incidence of postoperative lymphocele and were lower than the control group the incidence of two sides lymphocele were lower than the control group(P<0.05),the average maximum diameter of lymphocele was smaller than the control group,the difference between the two groups was statistically signifcant (P<0.05).Conclusions1. The operative time, the interoperative blood loss and drainage fluid volume were decreased by using ultrasonic scalpel or BiCamp in abdominal pelvic lymphadenectomy.2. The incidence of postoperative lymphocele in pelvic lymphadenectom was reduced by using ultrasonic scalpel and BiCamp.