Incidence of lymphedema and other complications in patients operated on for gynecological cancer including utilization of two lymph node dissection techniques

Abstract

Background: To assess the impact of the lymph node dissection (LND) technique on short- and long-term complications. This retrospective review included patients who underwent hysterectomy, oophorectomy, and pelvic ± para-aortic LND for gynecological malignancies (cervical, endometrial, and ovarian) from 2020 to 2022 in our Gynecological Oncology Surgery clinic. Methods and Results: Among 147 patients who underwent pelvic LND for gynecological malignancy, 48 had procedures involving scissors and 99 had procedures involving unipolar cautery. There was no significant difference in the numbers of extracted pelvic and para-aortic lymph nodes between groups. The extents of LND were comparable between the scissors and unipolar cautery groups (p = 0.945). The scissors group exhibited less fluid drainage between days 2 and 5 postoperatively (1300 [600-3100] vs 1800 [600-3400]; p = 0.038). In terms of primary early and late clinical outcomes, there were no significant differences in lymphocele (16.7% vs 15.2%; p = 0.494) and lymphedema (18.8% vs 17.2%; p = 0.491) rates between groups. Conclusions: After retroperitoneal LND for gynecological malignancy, early complications such as lymphocele and late complications such as lower extremity lymphedema did not significantly differ between procedures using cold scissors and procedures using unipolar cautery.