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. 2023 Nov 30;12(11):1622-1630.
doi: 10.21037/tau-23-416. Epub 2023 Nov 23.

Lymphoceles after pelvic lymph node dissection during robot-assisted radical prostatectomy

Jonas J L Meenderink #  1 , Lisa J Kroon #  1   2   3   4 , Margaretha A van der Slot  2   3 , Lionne D F Venderbos  1 , Geert J L H van Leenders  4 , Monique J Roobol  1 , Martijn B Busstra  1   2   3
Affiliations

Lymphoceles after pelvic lymph node dissection during robot-assisted radical prostatectomy

Jonas J L Meenderink et al. Transl Androl Urol. .

Abstract

Background: Lymphoceles, lymph fluid-filled collections within the body lacking epithelial lining, are a common complication after pelvic lymph node dissection (PLND) during robot-assisted radical prostatectomy (RARP). In this study, we investigate the incidence of imaging confirmed symptomatic lymphoceles (SLC) in a centralized high-volume operating centre and assess predictive factors and treatment.

Methods: We retrospectively analysed the incidence, risk factors and treatment of a consecutive series of patients who underwent PLND during RARP between September 2018 and January 2021 in a specialised operation clinic. We compared baseline patients' characteristics and pathological data between men who developed an SLC and those who did not. A multivariable model for the occurrence of an SLC was created using predetermined, clinically relevant variables to investigate predictive factors.

Results: We analysed the records of 404 patients. The median follow-up length was 29 months. A total of 30 (7.4%) patients with an SLC were identified. The median time until SLC presentation was 12 weeks [interquartile range (IQR), 4-31 weeks], one-third of SLCs presented after 180 days. Percutaneous drainage was performed in 17 patients (57%). On multivariable analysis, only body mass index (BMI) significantly increased the odds of an SLC [per 5 odds ratio (OR) =1.7; 95% confidence interval (CI): 1.0-3.0, P=0.04].

Conclusions: SLCs present significant consequences, as more than half of patients with an SLC were treated with percutaneous drainage. Many patients presented later than the centralized surgeons' postoperative follow-up, a drawback of centralized care. An increased BMI was a significant predictor for SLC.

Keywords: Lymph node excision; postoperative complications; prostate cancer; prostatic neoplasms; robotic surgical procedures.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tau.amegroups.com/article/view/10.21037/tau-23-416/coif). M.J.R. serves as an unpaid editorial board member of Translational Andrology and Urology from January 2022 to December 2023. L.J.K. reports that the Jaap Schouten Foundation provided a grant to financially support the PhD work of Lisa J. Kroon. The Jaap Schouten Foundation was not involved in the study design, materials, medical writing, article writing or processing changes of any kind; and also does not have a conflict of interest regarding study contents or results. The other authors have no conflicts of interest to declare.

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