Journal of Shandong University (Health Sciences) ›› 2020, Vol. 58 ›› Issue (1): 67-72.doi: 10.6040/j.issn.1671-7554.0.2019.1307

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Influencing factors of lymphatic leakage after laparoscopic radical cystectomy: an analysis of 160 cases

ZHANG Zhaopeng, XING Naidong, ZHANG Xiang, YAN Lei, XU Zhonghua   

  1. Department of Urology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
  • Published:2022-09-27

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Abstract: Objective To investigate the factors leading to lymphatic leakage after laparoscopic radical cystectomy(LRC), and to explore their roles in the prevention and treatment of postoperative lymphatic leakage. Methods The clinical data of 160 patients who underwent LRC at the Urology Department of Qilu Hospital of Shandong University from Jan. 2015 to Jan. 2019 were retrospectively analyzed and relevant literature was reviewed. The patients were divided into leakage group and non-leakage group. Patients age, lymph node dissection range, number of lymph nodes, number of positive lymph nodes, whether the lymphatic tissues were clapped with Hemolock after dissection, preoperative and postoperative hemoglobin(HGB), postoperative albumin(ALB)were collected to analyze factors associated with postoperative lymphatic leakage. Results Lymphatic leakage was detected in 44(27.5%)patients. One-way t-test and χ2 test showed the number of positive lymph nodes and whether lymphatic tissues were clamped with Hemolock after dissection were associated with occurrence of lymphatic leakage, and the latter could significantly reduce incidence of lymphatic leakage(t=2.477, χ2=41.215, P<0.05). Logistic regression analysis showed lymphatic leakage was associated with whether lymphatic tissues were clamped with Hemolock after dissection(OR=18.482, 95%CI:6.872-49.709, 山 东 大 学 学 报 (医 学 版)58卷1期 -张照鹏,等.160例腹腔镜根治性膀胱切除术后淋巴漏的影响因素分析 \=-P<0.001). All patients were cured after conservative treatment including fasting and unobstructed drainage. Conclusion The number of positive lymph nodes and whether lymphatic tissues are clamped with Hemolock after dissection are high risk factors of postoperative lymphatic leakage. Conservative treatment and adequate drainage can achieve satisfactory results. Skillful grasp of operation skills, clamping after lymph node dissection, good knowledge of anatomy and careful operation can prevent occurrence of lymphatic leakage.

Key words: Lymphatic leakage, Bladder cancer, Laparoscopic radical cystectomy, Pelvic lymph node dissection

CLC Number: 

  • R737.14
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