Clinical and Pathological Predictors of Prolonged Lymphorrhoea After Pelvic Lymph Dissection in Radical Cystectomy

INTRODUCTION: The aim of the study was to determine different variables that may be predictive for prolonged lymporrhoea and total days of drainage of lymph.
METHODS: Two hundreds and three patients who underwent radical cystectomy and retroperitoneal lymph node dissection were enrolled in this study. Lymphorrhoea was defined as the total amount of lymph drained by the drains until their removal. Total days of drainage were defined as the days until the removal of the last drains. Parameters that might be related to lymphorrhoea and total days of drainage including age, body mass index (BMI), removed lymph nodes, hemoglobin level (gr/dl), estimated blood loss (EBL), platelet count (PLN), hospital stay (HS) and lymph node status were reviewed, retrospectively. Statistical analyses were performed to determine the association between lymphorrhoea with probable predictors for these variables.
RESULTS: The mean number of removed lymph nodes was 28.52 (16-58). The mean amount of lymphorrhoea and total days of drainage was 1504 ml (300-5850) and 10.10 days (2-27), respectively. Multivariate analyses revealed that the mean amount of lymphorrhoea gradually rises as EBL, patients age, negative lymph nodes and lymphadenectomy extension increases (P<0.05). According to total days of drainage, multivariate analyses showed that BMI, number of removed lymph nodes were statistically significant predictors of prolonged drainage (p=0.016, p=0.046; respectively).
DISCUSSION AND CONCLUSION: Predictors for lymphorrhoea may help us mainly to foresee hospital duration and eventual complications that may be induced by lymphorrhoea. In patients with a higher risk for lymphorrhoea, preoperative maneuvers could be applied to decrease lymphorrhoea.