Clinical and pathological predictors of prolonged lymphorrhoea after pelvic lymph dissection in radical cystectomy

Abstract

The aim of the study was to determine different variables that may be predictive for prolonged lymporrhoea and duration of lymphatic drainage. Two hundred and three patients who underwent radical cystectomy (RC) and pelvic lymph node dissection (PLND) were enrolled in this study. Lymphorrhoea was defined as the total amount of lymph drained by the drains until their removal. Duration of drainage was defined as the days until the removal of the last drains. Parameters that might be related to lymphorrhoea and duration of drainage including age, body mass index (BMI), removed lymph nodes, hemoglobin level (gr/dl), estimated blood loss (ml) (EBL), platelet count (PLN), hospital stay (HS) and lymph node status were reviewed retrospectively. Statistical analyses were performed to determine the association between lymphorrhoea with probable predictors for these variables. The mean number of removed lymph nodes was 28.52 (16-58). The mean amount of lymphorrhoea and the duration of drainage were 1504 ml (300-5850) and 10.10 days (2-27), respectively. Multivariate analyses revealed that the mean amount of lymphorrhoea rises gradually as EBL, patients age, negative lymph nodes and lymphadenectomy extension increases (P<0.05). Related to the duration of drainage, multivariate analyses showed that BMI and the number of removed lymph nodes were statistically significant predictors of prolonged drainage (p=0.016, p=0.046; respectively). Predictors for lymphorrhoea may help us mainly to foresee the duration of the hospital stay and the eventual complications that may be induced by lymphorrhoea. In patients with a higher risk for lymphorrhoea, preoperative maneuvers could be applied to decrease lymphorrhoea. © 2020, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.