TY - JOUR
T1 - The achilles heel of minimally invasive inguinal lymph node dissection
T2 - Seroma formation: Seroma MILND
AU - Contreras, Nicolas
AU - Jakub, James W.
N1 - Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2020/4
Y1 - 2020/4
N2 - 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.
AB - 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.
KW - Minimally invasive inguinal lymph node dissection
KW - Post-operative complication
KW - Seroma
KW - Videoscopic
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U2 - 10.1016/j.amjsurg.2019.06.010
DO - 10.1016/j.amjsurg.2019.06.010
M3 - Article
C2 - 31256925
AN - SCOPUS:85067916363
SN - 0002-9610
VL - 219
SP - 696
EP - 700
JO - American journal of surgery
JF - American journal of surgery
IS - 4
ER -