The achilles heel of minimally invasive inguinal lymph node dissection: Seroma formation

Nicolas Contreras, James W Jakub

Research output: Contribution to journalArticle

Abstract

Objective: To describe the incidence of post-operative seroma and interventions attempted to reduce this complication in patients undergoing minimally invasive inguinal lymph node dissection (MILND). Background: MILND has resulted in fewer wound complications, hospital readmissions, and shorter length of stay; unfortunately, seroma formation remains a major source of morbidity. Methods: A retrospective study of MILNDs performed from 2010 to 2017 was conducted. Different interventions were trialed attempting to combat this problem. We report the analysis with respect to seroma formation. Results: Forty-one patients underwent 44 MILND. Twenty-two (50%) patients developed symptomatic seroma requiring aspiration and/or drain placement. Risk factors associated with seroma on univariate analysis were increased number of metastatic nodes (p = 0.028), increasing BMI (p = 0.046), increasing age (p = 0.056), and larger suction drain bulbs (p = 0.013). There was an association with postoperative seroma formation and post-operative lymphedema (p = 0.001). Multiple interventions trialed to reduce seroma formation were unsuccessful in reducing the seroma rate. Conclusion: Seromas formation continues to be a common morbidity following MILND. Further research is needed to determine how seroma incidence can be reduced in patients undergoing MILND.

Original languageEnglish (US)
JournalAmerican journal of surgery
DOIs
StatePublished - Jan 1 2019

Fingerprint

Seroma
Groin
Lymph Node Excision
Morbidity
Patient Readmission
Lymphedema
Incidence
Suction
Length of Stay
Retrospective Studies

Keywords

  • Minimally invasive inguinal lymph node dissection
  • Post-operative complication
  • Seroma
  • Videoscopic

ASJC Scopus subject areas

  • Surgery

Cite this

The achilles heel of minimally invasive inguinal lymph node dissection : Seroma formation. / Contreras, Nicolas; Jakub, James W.

In: American journal of surgery, 01.01.2019.

Research output: Contribution to journalArticle

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abstract = "Objective: To describe the incidence of post-operative seroma and interventions attempted to reduce this complication in patients undergoing minimally invasive inguinal lymph node dissection (MILND). Background: MILND has resulted in fewer wound complications, hospital readmissions, and shorter length of stay; unfortunately, seroma formation remains a major source of morbidity. Methods: A retrospective study of MILNDs performed from 2010 to 2017 was conducted. Different interventions were trialed attempting to combat this problem. We report the analysis with respect to seroma formation. Results: Forty-one patients underwent 44 MILND. Twenty-two (50{\%}) patients developed symptomatic seroma requiring aspiration and/or drain placement. Risk factors associated with seroma on univariate analysis were increased number of metastatic nodes (p = 0.028), increasing BMI (p = 0.046), increasing age (p = 0.056), and larger suction drain bulbs (p = 0.013). There was an association with postoperative seroma formation and post-operative lymphedema (p = 0.001). Multiple interventions trialed to reduce seroma formation were unsuccessful in reducing the seroma rate. Conclusion: Seromas formation continues to be a common morbidity following MILND. Further research is needed to determine how seroma incidence can be reduced in patients undergoing MILND.",
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