Preoperative Parameters to Predict the Development of Symptomatic Lymphoceles after Radical Prostatectomy

Mahjoub, Samy ORCID: 0000-0001-5151-1853, Hennecken, Marius, Pfister, David, Hartmann, Florian, John, Patricia, Schmautz, Maximilian and Heidenreich, Axel . Preoperative Parameters to Predict the Development of Symptomatic Lymphoceles after Radical Prostatectomy. Urol.Int.. BASEL: KARGER. ISSN 1423-0399

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DOI:10.1159/000514041

Abstract

Introduction: Symptomatic lymphoceles (SLs) represent the most common complication after radical prostatectomy (RP) and pelvic lymph node dissection (PLND). To date, preoperative risk factors are missing. Methods: Clinical and pathological data of 592 patients who underwent RP and PLND were evaluated. Included parameters were age, BMI, prostate-specific antigen (PSA), PSA ratio, PSA density, number of resected and/or positive lymph nodes, previous abdominal surgery/pelvic radiotherapy, anticoagulation, and surgical approach. Results: Fifty-nine patients (10%) developed an SL, of which 57 underwent open retropubic radical prostatectomy (RRP) and 2 underwent robot-assisted radical prostatectomy (RARP). Multivariate logistic regression revealed the following parameters as statistically significant risk factors: PSA (odds ratio [OR] = 2.23; 95% CI [1.25; 5.04], p = 0.04), number of resected lymph nodes (OR = 1.47; 95% CI [1.10; 1.97], p < 0.01), previous abdominal surgery (OR = 2.58; 95% CI [1.38; 4.91], p < 0.01), and surgical approach (OR = 0.08; 95% CI [0.01; 0.27], p < 0.01). Previous oral anticoagulation showed almost statistically significant results (OR = 2.39 [0.92; 5.51], p = 0.05). Conclusion: The risk for SL might be predictable considering preoperative risk factors such as PSA, previous abdominal surgery and anticoagulation. To avoid SL, RARP should be the procedure of choice. If RRP is considered, patients at risk for SL may benefit from peritoneal fenestration during RP.

Item Type:

Journal Article

Creators:

Creators	Email	ORCID	ORCID Put Code
Mahjoub, Samy	UNSPECIFIED	orcid.org/0000-0001-5151-1853	UNSPECIFIED
Hennecken, Marius	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Pfister, David	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Hartmann, Florian	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
John, Patricia	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Schmautz, Maximilian	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Heidenreich, Axel	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED