Omentoplasty and omentopexy post-pelvic lymph node dissection in surgical management of gynecological tumors

Mohamed Salama Mohamed; Karim Mohamed Salama; Mohamed Esmail; Nada Mohsen Salama; Ghada Mohamed; Shaimaa Abdalaleem Abdalgeleel; Ahmed Amin Abogabal; Ayman Abo Elregal; Marwa Mahmoud Selim; Ayman Hanafy

doi:10.53730/ijhs.v6nS6.11767

Authors

Mohamed Salama Mohamed
m_salama201010@yahoo.com
Surgical oncology department, National Cancer Institute, Cairo University, Egypt
Karim Mohamed Salama Obstetrics and Gynecology Department, Kasr ElAini, Cairo University, Egypt
Mohamed Esmail Obstetrics and Gynecology Department, Kasr ElAini, Cairo University, Egypt
Nada Mohsen Salama Radiology department, National Cancer Institute, Cairo University, Egypt
Ghada Mohamed Pathology department, National Cancer Institute, Cairo University, Egypt
Shaimaa Abdalaleem Abdalgeleel Biostatistics and epidemiology department, National Cancer Institute, Cairo University, Egypt
Ahmed Amin Abogabal Radiotherapy department, National Cancer Institute, Cairo University, Egypt
Ayman Abo Elregal Radiology department, National Cancer Institute, Cairo University, Egypt
Marwa Mahmoud Selim Medical oncology department, National Cancer Institute, Cairo University, Egypt
Ayman Hanafy Surgical oncology department, National Cancer Institute, Cairo University, Egypt

Keywords:

lymphocyst, pelvic lyphadenectomy, omenoplasty-omentopexy

Abstract

Background: Lymphadenectomy is performed as a staging procedure in patients with pelvic gynecological malignancies, However, pelvic lymphadenectomy was associated with morbidities such as lymphedema or lymphocysts, Omentoplasty-omentopexy has been utilized for prevention of lymphocysts that develop following pelvic lymphadenectomy. Patients and methods: This study is a randomized controlled trial. Forty-one consecutive patients who were candidates for pelvic lymphadenectomy during radical hysterectomy for cancer cervix or endometrium were enrolled in this study and were allocated to two groups. Intervention group (Omentoplasty-Omentopexy -A- group) included twenty-one patients who underwent omentoplasty-omentopexy. Control group -B- group included twenty patients who did not underwent omentoplasty-omentopexy. The two groups were compared regarding development of lymphocyst. The study was done at the National Cancer Institute, Cairo University from January 2020 to June 2021. Results: Forty-one consecutive patients were enrolled in this study from January 2020 to June 2021. with an average age 58.9±12.4 years, no statistically significant difference between the Omentoplasty-Omentopexy (A) and control group (B) regarding tumor site and histopathologic tumor types and tumor grade.

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References

-Conte M, Panici PB, Guariglia L, Scambia G, Greggi S, Mancuso S. Pelvic lymphocele following radical paraaortic and pelvic lymphadenectomy for cervical carcinoma: incidence rate and percutaneous management. Obstet Gynecol 1990;76:268—71.

-Petru E, Tamussino K, Lahousen M, Winter R, Pickel H, Haas J. Pelvic and paraaortic lymphocysts after radical surgery because of cervical and ovarian cancer. Am J Obstet Gynecol 1989;161:937—41.

- Selman TJ, Mann ChH, Zamora J, Khan KS. A systematic review of tests for lymph node status in primary endometrial cancer. BMC Women’s Health2008;8:8.

- Selman TJ, Mann Ch, Zamora J, Appleyard TL, Khan K. Diagnostic accuracy of tests for lymph node status in primary cervical cancer: a systematic review and meta analysis. CMAJ 2008;178(7):855–62.

- Ancona E, Rigotti P, Zaninotto G, Comandella MG,Morpurgo E, Costantini M. Treatment of lymphocele following renal transplantation by laparoscopic surgery.Int Surg 1991;76:261—3.

- Tam KF, Lam KW, Chan KK, Ngan HY. Natural history of pelvic lymphocysts as observed by. Ultrasound Obstet Gynecol 2008;32:87–90.

- Scholz HS, Petru E, Benedicic C, Haas J, Tamussino K, Winter R. Fibrin application for preventing lymphocysts after retroperitonal lymphadenectomy inpatients with gynecologic malignancies. Gynecol Oncol 2002;84:43–6.

-Logmans A, Kruyt RH, de Bruin HG, Cox PH, Pillay M, Trimbos JB. Lymphedema and lymphocysts following lymphadenectomy may be prevented by omentoplasty:a pilot study. Gynecol Oncol 1999;75:323–7.

-Benedetti-Panici P, Maneschi F, Cutillo G, et al. A randomized study comparing retroperitoneal drainage with no drainage after lymphadenectomy in gynecologic malignancies. Gynecol Oncol 1997;65:478–82.

-Suzuki M, Ohwada M, Sato I. Pelvic lymphocysts following retroperitoneal lymphadenectomy. Retro peritoneal partial ‘no-closure’ for ovarian and endometrial cancers.J Surg Oncol 1998;68:149—52.

-Yamamoto R, Saitoh T, Kusaka T et al. Prevention of lymphocyst formation following systematic lymphadenectomy.Jpn J Clin Oncol 2000;30:397—400.

-Patsner B. Closed-suction drainage versus no drainage following radical abdominal hysterectomy with pelvic lymphadenectomy for stage IB cervical cancer. GynecolOncol 1995;57:232—4.

-Patsner B, Hackett TE. Use of the omental J-flap for prevention of postoperative complications following radical abdominal hysterectomy: report of 140 cases and literature review. Gynecol Oncol 1997;65:405—7.

-Logmans A, Trimbos JB, van Lent M. The omentoplasty:a neglected ally in gynecologic surgery. Eur J ObstetGynecolReprod Biol 1995;58:167—71.

-Kragt H, Bouma J, Aalders JG. Anticoagulants and the formation of lymphocysts after pelvic lymphadenectomy in gynecologic and oncologic operations. Surg GynecolObstet 1986;162:361-4.

- GoldsmithHS, de los SR. Omental transposition in primary lymphedema. Surg GynecolObstet 1967;125:607—10.

- Fujiwara K, Kigawa J, Hasegawa K, et al. Effect of simple omentoplasty and omentopexy in the prevention of complications after pelvic lymphadenectomy.Int J Gastrointest Cancer 2003;13:61–6.

- Benoit L, Boichot C, Cheynel N, et al. Preventing lymphedema and morbidity in an omentum flap after ilioinguinal lymph node dissection. Ann SurgOncol 2005;12:793–9.

- Weinberger V, Cibula D, Zikan M. Lymphocele: prevalence and management in gynecological malignancies. Expert Rev Anticancer Ther. 2014;14:307–317.

- Mori N. Clinical and experimental studies on the so-called lymphocyst which develops after radical hysterectomy in cancer of the uterine cervix. J Jpn ObstetGynecol Soc. 1955;2:178–203.

- Rutledge F, Dodd G D jr., Kasilag F B jr.. Lymphocysts; a complication of radical pelvic surgery. Am J Obstet Gynecol. 1959;77:1165–1175.

- Kim H Y, Kim J W, Kim S H. et al. An analysis of the risk factors and management of lymphocele after pelvic lymphadenectomy in patients with gynecologic malignancies. Cancer Res Treat. 2004;36:377–383.

-Petru E, Tamussino K, Lahousen M. et al. Pelvic and paraaortic lymphocysts after radical surgery because of cervical and ovarian cancer. Am J Obstet Gynecol. 1989;161:937–941.

-Zikan M, Fischerova D, Pinkavova I. et al. A prospective study examining the incidence of asymptomatic and symptomatic lymphoceles following lymphadenectomy in patients with gynecological cancer. Gynecol Oncol. 2015;137:291–298.

-Achouri A, Huchon C, Bats A S. et al. Complications of lymphadenectomy for gynecologic cancer. Eur J Surg Oncol. 2013;39:81–86.

-Shimotsuma M, Hagiwara A, Takahashi T, Kawata M, Shields JW. Surface structure and cell zonation in human omental milky spots. Lymphology1990;23:207–8.

- Liebermann-Meffert D, White H (eds): The Greater Omentum: Anatomy, Physiology,

Pathology, Surgery, with an Historical Survey. New York, Springer, 1983, pp 1-369.

-Achouri A, Huchon C, Bats A S. et al. Postoperative lymphocysts after lymphadenectomy for gynaecological malignancies: preventive techniques and prospects. Eur J ObstetGynecolReprod Biol. 2012;161:125–129.