New technique reduces postoperative complications in prostate cancer surgery (Lymphatic fluid issues reduced 50+%)

Medical Xpress / European Assoc of Urology / 2023 European Association of Urology annual Congress ^ | March 12, 2023 | Professor Philip Nuhn et al

[ConservativeMind]

Surgeons have shown a small technical change to keyhole surgery for prostate cancer can more than halve one of the most common post-operative complications—where lymphatic fluid collects in the pelvis.

The technique involves creating a small flap in the peritoneum—the lining of the abdomen—and attaching this flap down into the pelvis. This creates a route for lymphatic fluid to escape from the pelvis into the abdomen where it can be more easily absorbed.

Around 10 percent of patients whose prostate cancer and lymph nodes are removed through robot-assisted keyhole surgery require treatment for symptoms caused by lymphatic fluid collecting in the pelvis, known as lymphocele. Lymphocele can also be seen in nearly a third of patients when they were systematically checked, without them reporting symptoms.

Symptoms include superinfection, pain in the pelvis, pressure on the bladder, and swollen legs due to compression of the veins. If left untreated, symptomatic lymphocele can lead to serious infections or deep vein thrombosis.

Draining a lymphocele can take from three days to three weeks, with treatment complete only when the fluid is no longer accumulating. For some patients, this requires a stay in hospital.

The trial involved over 550 patients.

During the six month follow-up period, only 10 patients in the peritoneal flap group had developed a symptomatic lymphocele, compared to 25 in the control group. At the time of discharge, 20 patients in the flap group had lymphocele with no symptoms, compared to 46 in the control group. During the follow-up, this had risen to just 27 in the flap group, but 74 in the control group.

Professor Philip Nuhn said, "Using the peritoneal flap reduced the incidence of lymphocele from nine percent to less than four percent. We now use this as the new standard in Mannheim."

[ConservativeMind]

This surgery is easy to perform and can be done today.

[ConservativeMind]

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