Preventing lymphedema and morbidity with an omentum flap after ilioinguinal lymph node dissection.
Fiche publication
Date publication
octobre 2005
Auteurs
Membres identifiés du Cancéropôle Est :
Dr ARNOULD Laurent
Tous les auteurs :
Benoit L, Boichot C, Cheynel N, Arnould L, Chauffert B, Cuisenier J, Fraisse J
Lien Pubmed
Résumé
BACKGROUND: Pedicled omentoplasty has been advocated to prevent the formation of lymphocysts and lymphedema after pelvic lymph node dissection, We evaluated the possible benefit of a pediculated omentoplasty placed in the groin for preventing complications after ilioinguinal lymph node dissection. METHODS: In this pilot study, we report a series of four women and three men with inguinal metastatic lymph nodes. Each was treated with a pediculated omentoplasty after groin dissection. We examined complications such as lymphedema, lymphorrhea, wound breakdown, skin necrosis, and lymphocysts. RESULTS: Only one wound breakdown with skin necrosis was observed, and it healed satisfactorily in 10 days without exposing the femoral vessels. No lymphocele or infectious complications occurred, even though no antibiotic prophylaxis was used. Midthigh circumference increase ranged from 1.5 to 7 cm in four cases but remained asymptomatic. Furthermore, lymphedema of the lower limb decreased in the three remaining patients, who previously had an enlargement of the thigh. No evidence of peritoneal carcinomatosis was noted during the 4-month follow-up. CONCLUSIONS: Pedicled omentoplasty seemed to facilitate the absorption or transport of lymph fluids and resulted in less lymphedema in the lower limb even after radiotherapy. Pedicled omentoplasty reduces both short-term and long-term postoperative complications without affecting treatment outcome and could even be considered as a safe and effective therapy for lymphedema of the lower extremity.
Référence
Ann Surg Oncol. 2005 Oct;12(10):793-9