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Erschienen in: Annals of Surgical Oncology 1/2012

01.01.2012 | Gynecologic Oncology

Lymphoceles, Lymphorrhea, and Lymphedema after Laparoscopic and Open Endometrial Cancer Staging

verfasst von: Fabio Ghezzi, MD, Stefano Uccella, MD, Antonella Cromi, PhD, Giorgio Bogani, MD, Claudio Robba, MD, Maurizio Serati, MD, Pierfrancesco Bolis, MD

Erschienen in: Annals of Surgical Oncology | Ausgabe 1/2012

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Abstract

Purpose

To evaluate the incidence of lymphoceles, lymphorrhea, and lymphedema after systematic pelvic lymphadenectomy in patients who underwent laparoscopic or open abdominal staging for endometrial cancer.

Methods

A total of 138 consecutive women who underwent systematic laparoscopic pelvic lymphadenectomy for endometrial cancer staging were compared to 123 historical control subjects staged via an open approach. Postoperative screening for lymphadenectomy-related complications by ultrasound was consistently performed.

Results

The incidence of perioperative complications was lower in cases than in control subjects. Overall, lymphoceles were diagnosed in 19 (15.4%) and 2 (1.4%) patients who had open and laparoscopic staging, respectively (odds ratio 12.42; 95% confidence interval 2.82–54.55; P < 0.0001). Symptomatic lymphoceles were more frequent after open staging than after laparoscopy (P = 0.028). Lymphorrhea occurred in 1 and 4 patients after laparoscopic and open surgery (P = 0.19). No difference in the incidence of lymphedema was observed.

Conclusions

Our findings suggest that laparoscopic endometrial cancer staging is associated with a lower occurrence of both asymptomatic and symptomatic lymphoceles compared to open surgery.
Literatur
1.
Zurück zum Zitat Mori N. Clinical and experimental studies on the so-called lymphocyst which develops after radical hysterectomy in cancer of the uterine cervix. J Jpn Obstet Gynecol Soc. 1955;2:178–203.PubMed Mori N. Clinical and experimental studies on the so-called lymphocyst which develops after radical hysterectomy in cancer of the uterine cervix. J Jpn Obstet Gynecol Soc. 1955;2:178–203.PubMed
2.
Zurück zum Zitat Querleu D, Leblanc E, Cartron G, Narducci F, Ferron G, Martel P. Audit of preoperative and early complications of laparoscopic lymph node dissection in 1000 gynecologic cancer patients. Am J Obstet Gynecol. 2006;195:1287–92.PubMedCrossRef Querleu D, Leblanc E, Cartron G, Narducci F, Ferron G, Martel P. Audit of preoperative and early complications of laparoscopic lymph node dissection in 1000 gynecologic cancer patients. Am J Obstet Gynecol. 2006;195:1287–92.PubMedCrossRef
3.
Zurück zum Zitat Petru E, Tamussino K, Lahousen M, Winter R, Pickel H, Haas J. Pelvic and paraaortic lymphocysts after radical surgery because of cervical and ovarian cancer. Am J Obstet Gynecol. 1989;161:937–41.PubMed Petru E, Tamussino K, Lahousen M, Winter R, Pickel H, Haas J. Pelvic and paraaortic lymphocysts after radical surgery because of cervical and ovarian cancer. Am J Obstet Gynecol. 1989;161:937–41.PubMed
4.
Zurück zum Zitat Conte M, Benedetti-Panici P, Guariglia L, Scambia G, Greggi S, Mancuso S. Pelvic lymphocele following radical para-aortic and pelvic lymphadenectomy for cervical carcinoma: incidence rate and percutaneous management. Obstet Gynecol. 1990;76:268–71.PubMed Conte M, Benedetti-Panici P, Guariglia L, Scambia G, Greggi S, Mancuso S. Pelvic lymphocele following radical para-aortic and pelvic lymphadenectomy for cervical carcinoma: incidence rate and percutaneous management. Obstet Gynecol. 1990;76:268–71.PubMed
5.
Zurück zum Zitat Clarke-Pearson DL, Synan IS, Creasman WT. Significant venous thromboembolism caused by pelvic lymphocysts: diagnosis and management. Gynecol Oncol. 1982;13:136–43.PubMedCrossRef Clarke-Pearson DL, Synan IS, Creasman WT. Significant venous thromboembolism caused by pelvic lymphocysts: diagnosis and management. Gynecol Oncol. 1982;13:136–43.PubMedCrossRef
6.
Zurück zum Zitat Ilancheran A, Monaghan JM. Pelvic lymphocyst—a 10 year experience. Gynecol Oncol. 1988;29:333–6.PubMedCrossRef Ilancheran A, Monaghan JM. Pelvic lymphocyst—a 10 year experience. Gynecol Oncol. 1988;29:333–6.PubMedCrossRef
7.
Zurück zum Zitat Varga Z, Hegele A, Olbert P, Hofmann R, Schrader AJ. Laparoscopic peritoneal drainage of symptomatic lymphoceles after pelvic lymph node dissection using methylene blue installation. Urol Int. 2006;76:335–8.PubMedCrossRef Varga Z, Hegele A, Olbert P, Hofmann R, Schrader AJ. Laparoscopic peritoneal drainage of symptomatic lymphoceles after pelvic lymph node dissection using methylene blue installation. Urol Int. 2006;76:335–8.PubMedCrossRef
8.
Zurück zum Zitat Kitchener H, Swart AM, Qian Q, Amos C, Parmar MK. Efficacy of systematic pelvic lymphadenectomy in endometrial cancer (MRC ASTEC trial): a randomised study. Lancet. 2009;373:125–36.PubMedCrossRef Kitchener H, Swart AM, Qian Q, Amos C, Parmar MK. Efficacy of systematic pelvic lymphadenectomy in endometrial cancer (MRC ASTEC trial): a randomised study. Lancet. 2009;373:125–36.PubMedCrossRef
9.
Zurück zum Zitat Kim K, Ryu SY. Major clinical research advances in gynecologic cancer 2009. J Gynecol Oncol. 2009;20:203–9.PubMedCrossRef Kim K, Ryu SY. Major clinical research advances in gynecologic cancer 2009. J Gynecol Oncol. 2009;20:203–9.PubMedCrossRef
10.
Zurück zum Zitat Benedetti Panici P, Basile S, Maneschi F, Alberto Lissoni A, Signorelli M, Scambia G, et al. Systematic pelvic lymphadenectomy vs. no lymphadenectomy in early-stage endometrial carcinoma: randomized clinical trial. J Natl Cancer Inst. 2008;100:1707–16.PubMedCrossRef Benedetti Panici P, Basile S, Maneschi F, Alberto Lissoni A, Signorelli M, Scambia G, et al. Systematic pelvic lymphadenectomy vs. no lymphadenectomy in early-stage endometrial carcinoma: randomized clinical trial. J Natl Cancer Inst. 2008;100:1707–16.PubMedCrossRef
11.
Zurück zum Zitat Uccella S, Podratz KC, Aletti GD, Mariani A. Lymphadenectomy in endometrial cancer. Lancet. 2009;373:1170 (author reply 1170–1).PubMedCrossRef Uccella S, Podratz KC, Aletti GD, Mariani A. Lymphadenectomy in endometrial cancer. Lancet. 2009;373:1170 (author reply 1170–1).PubMedCrossRef
12.
Zurück zum Zitat Uccella S, Podratz KC, Aletti GD, Mariani A. Re: Systematic pelvic lymphadenectomy vs. no lymphadenectomy in early-stage endometrial carcinoma: randomized clinical trial. J Natl Cancer Inst. 2009;101:897–8 (author reply 898–9).PubMedCrossRef Uccella S, Podratz KC, Aletti GD, Mariani A. Re: Systematic pelvic lymphadenectomy vs. no lymphadenectomy in early-stage endometrial carcinoma: randomized clinical trial. J Natl Cancer Inst. 2009;101:897–8 (author reply 898–9).PubMedCrossRef
13.
Zurück zum Zitat Tinelli R, Malzoni M, Cicinelli E, Fiaccavento A, Zaccoletti R, Barbieri F, et al. Is early stage endometrial cancer safely treated by laparoscopy? Complications of a multicenter study and review of recent literature. Surg Oncol. 2011;20:80–7.PubMedCrossRef Tinelli R, Malzoni M, Cicinelli E, Fiaccavento A, Zaccoletti R, Barbieri F, et al. Is early stage endometrial cancer safely treated by laparoscopy? Complications of a multicenter study and review of recent literature. Surg Oncol. 2011;20:80–7.PubMedCrossRef
14.
Zurück zum Zitat Ghezzi F, Cromi A, Uccella S, Siesto G, Zefiro F, Bolis P. Incorporating laparoscopy in the practice of a gynecologic oncology Service: actual impact beyond clinical trials data. Ann Surg Oncol. 2009;16:2305–14.PubMedCrossRef Ghezzi F, Cromi A, Uccella S, Siesto G, Zefiro F, Bolis P. Incorporating laparoscopy in the practice of a gynecologic oncology Service: actual impact beyond clinical trials data. Ann Surg Oncol. 2009;16:2305–14.PubMedCrossRef
15.
Zurück zum Zitat Ghezzi F, Cromi A, Uccella S, Siesto G, Giudici S, Serati M, et al. Laparoscopic versus open surgery for endometrial cancer: a minimum 3-year follow-up study. Ann Surg Oncol. 2010;17:271–8.PubMedCrossRef Ghezzi F, Cromi A, Uccella S, Siesto G, Giudici S, Serati M, et al. Laparoscopic versus open surgery for endometrial cancer: a minimum 3-year follow-up study. Ann Surg Oncol. 2010;17:271–8.PubMedCrossRef
16.
Zurück zum Zitat Ghezzi F, Cromi A, Bergamini V, Uccella S, Beretta P, Franchi M, et al. Laparoscopic management of endometrial cancer in nonobese and obese women: a consecutive series. J Minim Invasive Gynecol. 2006;13:269–75.PubMedCrossRef Ghezzi F, Cromi A, Bergamini V, Uccella S, Beretta P, Franchi M, et al. Laparoscopic management of endometrial cancer in nonobese and obese women: a consecutive series. J Minim Invasive Gynecol. 2006;13:269–75.PubMedCrossRef
17.
Zurück zum Zitat Ghezzi F, Cromi A, Bergamini V, Uccella S, Beretta P, Franchi M, et al. Laparoscopic-assisted vaginal hysterectomy versus total laparoscopic hysterectomy for the management of endometrial cancer: a randomized clinical trial. J Minim Invasive Gynecol. 2006;13:114–20.PubMedCrossRef Ghezzi F, Cromi A, Bergamini V, Uccella S, Beretta P, Franchi M, et al. Laparoscopic-assisted vaginal hysterectomy versus total laparoscopic hysterectomy for the management of endometrial cancer: a randomized clinical trial. J Minim Invasive Gynecol. 2006;13:114–20.PubMedCrossRef
18.
Zurück zum Zitat Pecorelli S. Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. Int J Gynaecol Obstet. 2009;105:103–4.PubMedCrossRef Pecorelli S. Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. Int J Gynaecol Obstet. 2009;105:103–4.PubMedCrossRef
19.
Zurück zum Zitat Logmans A, Kruyt RH, de Bruin HG, Cox PH, Pillay M, Trimbos JB. Lymphedema and lymphocysts following lymphadenectomy may be prevented by omentoplasty: a pilot study. Gynecol Oncol. 1999;75:323–7.PubMedCrossRef Logmans A, Kruyt RH, de Bruin HG, Cox PH, Pillay M, Trimbos JB. Lymphedema and lymphocysts following lymphadenectomy may be prevented by omentoplasty: a pilot study. Gynecol Oncol. 1999;75:323–7.PubMedCrossRef
20.
Zurück zum Zitat Suzuki M, Ohwada M, Sato I. Pelvic lymphocysts following retroperitoneal lymphadenectomy: retroperitoneal partial “no-closure” for ovarian and endometrial cancers. J Surg Oncol. 1998;68:149–52.PubMedCrossRef Suzuki M, Ohwada M, Sato I. Pelvic lymphocysts following retroperitoneal lymphadenectomy: retroperitoneal partial “no-closure” for ovarian and endometrial cancers. J Surg Oncol. 1998;68:149–52.PubMedCrossRef
21.
Zurück zum Zitat Scholz HS, Petru E, Benedicic C, Haas J, Tamussino K, Winter R. Fibrin application for preventing lymphocysts after retroperitoneal lymphadenectomy in patients with gynecologic malignancies. Gynecol Oncol. 2002;84:43–6.PubMedCrossRef Scholz HS, Petru E, Benedicic C, Haas J, Tamussino K, Winter R. Fibrin application for preventing lymphocysts after retroperitoneal lymphadenectomy in patients with gynecologic malignancies. Gynecol Oncol. 2002;84:43–6.PubMedCrossRef
22.
Zurück zum Zitat Yamamoto R, Saitoh T, Kusaka T, Todo Y, Takeda M, Okamoto K, et al. Prevention of lymphocyst formation following systematic lymphadenectomy. Jpn J Clin Oncol. 2000;30:397–400.PubMedCrossRef Yamamoto R, Saitoh T, Kusaka T, Todo Y, Takeda M, Okamoto K, et al. Prevention of lymphocyst formation following systematic lymphadenectomy. Jpn J Clin Oncol. 2000;30:397–400.PubMedCrossRef
23.
Zurück zum Zitat Charoenkwan K, Kietpeerakool C. Retroperitoneal drainage versus no drainage after pelvic lymphadenectomy for the prevention of lymphocyst formation in patients with gynaecological malignancies. Cochrane Database Syst Rev. 2010;(1):CD007387. Charoenkwan K, Kietpeerakool C. Retroperitoneal drainage versus no drainage after pelvic lymphadenectomy for the prevention of lymphocyst formation in patients with gynaecological malignancies. Cochrane Database Syst Rev. 2010;(1):CD007387.
24.
Zurück zum Zitat Gallotta V, Fanfani F, Rossitto C, Vizzielli G, Testa A, Scambia G, et al (2010) A randomized study comparing the use of the Ligaclip with bipolar energy to prevent lymphocele during laparoscopic pelvic lymphadenectomy for gynecologic cancer. Am J Obstet Gynecol 2010;203:483.e1–6.CrossRef Gallotta V, Fanfani F, Rossitto C, Vizzielli G, Testa A, Scambia G, et al (2010) A randomized study comparing the use of the Ligaclip with bipolar energy to prevent lymphocele during laparoscopic pelvic lymphadenectomy for gynecologic cancer. Am J Obstet Gynecol 2010;203:483.e1–6.CrossRef
25.
Zurück zum Zitat Boggess JF, Gehrig PA, Cantrell L, Shafer A, Ridgway M, Skinner EN, et al (2008) A comparative study of 3 surgical methods for hysterectomy with staging for endometrial cancer: robotic assistance, laparoscopy, laparotomy. Am J Obstet Gynecol. 2008;199:360.e1–9. CrossRef Boggess JF, Gehrig PA, Cantrell L, Shafer A, Ridgway M, Skinner EN, et al (2008) A comparative study of 3 surgical methods for hysterectomy with staging for endometrial cancer: robotic assistance, laparoscopy, laparotomy. Am J Obstet Gynecol. 2008;199:360.e1–9. CrossRef
26.
Zurück zum Zitat Cho YH, Kim DY, Kim JH, Kim YM, Kim YT, Nam JH. Laparoscopic management of early uterine cancer: 10-year experience in Asan Medical Center. Gynecol Oncol. 2007;106:585–90.PubMedCrossRef Cho YH, Kim DY, Kim JH, Kim YM, Kim YT, Nam JH. Laparoscopic management of early uterine cancer: 10-year experience in Asan Medical Center. Gynecol Oncol. 2007;106:585–90.PubMedCrossRef
27.
Zurück zum Zitat Devaja O, Samara I, Papadopoulos AJ. Laparoscopically assisted vaginal hysterectomy (LAVH) versus total abdominal hysterectomy (TAH) in endometrial carcinoma: prospective cohort study. Int J Gynecol Cancer. 2010;20:570–5.PubMedCrossRef Devaja O, Samara I, Papadopoulos AJ. Laparoscopically assisted vaginal hysterectomy (LAVH) versus total abdominal hysterectomy (TAH) in endometrial carcinoma: prospective cohort study. Int J Gynecol Cancer. 2010;20:570–5.PubMedCrossRef
28.
Zurück zum Zitat Eisenkop SM. Total laparoscopic hysterectomy with pelvic/aortic lymph node dissection for endometrial cancer—a consecutive series without case selection and comparison to laparotomy. Gynecol Oncol. 2010;117:216–23.PubMedCrossRef Eisenkop SM. Total laparoscopic hysterectomy with pelvic/aortic lymph node dissection for endometrial cancer—a consecutive series without case selection and comparison to laparotomy. Gynecol Oncol. 2010;117:216–23.PubMedCrossRef
29.
Zurück zum Zitat Eltabbakh GH. Analysis of survival after laparoscopy in women with endometrial carcinoma. Cancer. 2002;95:1894–901.PubMedCrossRef Eltabbakh GH. Analysis of survival after laparoscopy in women with endometrial carcinoma. Cancer. 2002;95:1894–901.PubMedCrossRef
30.
Zurück zum Zitat Frigerio L, Gallo A, Ghezzi F, Trezzi G, Lussana M, Franchi M. Laparoscopic-assisted vaginal hysterectomy versus abdominal hysterectomy in endometrial cancer. Int J Gynaecol Obstet. 2006;93:209–13.PubMedCrossRef Frigerio L, Gallo A, Ghezzi F, Trezzi G, Lussana M, Franchi M. Laparoscopic-assisted vaginal hysterectomy versus abdominal hysterectomy in endometrial cancer. Int J Gynaecol Obstet. 2006;93:209–13.PubMedCrossRef
31.
Zurück zum Zitat Gil-Moreno A, Díaz-Feijoo B, Morchón S, Xercavins J. Analysis of survival after laparoscopic-assisted vaginal hysterectomy compared with the conventional abdominal approach for early-stage endometrial carcinoma: a review of the literature. J Minim Invasive Gynecol. 2006;13:26–35.PubMedCrossRef Gil-Moreno A, Díaz-Feijoo B, Morchón S, Xercavins J. Analysis of survival after laparoscopic-assisted vaginal hysterectomy compared with the conventional abdominal approach for early-stage endometrial carcinoma: a review of the literature. J Minim Invasive Gynecol. 2006;13:26–35.PubMedCrossRef
32.
Zurück zum Zitat Hahn HS, Kim HJ, Yoon SG, Kim WC, Choi HJ, Kim HS, et al. Laparoscopy-assisted vaginal versus abdominal hysterectomy in endometrial cancer. Int J Gynecol Cancer. 2010;20:102–9.PubMedCrossRef Hahn HS, Kim HJ, Yoon SG, Kim WC, Choi HJ, Kim HS, et al. Laparoscopy-assisted vaginal versus abdominal hysterectomy in endometrial cancer. Int J Gynecol Cancer. 2010;20:102–9.PubMedCrossRef
33.
Zurück zum Zitat Janda M, Gebski V, Brand A, Hogg R, Jobling TW, Land R, et al. Quality of life after total laparoscopic hysterectomy versus total abdominal hysterectomy for stage I endometrial cancer (LACE): a randomised trial. Lancet Oncol. 2010;11:772–80.PubMedCrossRef Janda M, Gebski V, Brand A, Hogg R, Jobling TW, Land R, et al. Quality of life after total laparoscopic hysterectomy versus total abdominal hysterectomy for stage I endometrial cancer (LACE): a randomised trial. Lancet Oncol. 2010;11:772–80.PubMedCrossRef
34.
Zurück zum Zitat Kim DY, Kim MK, Kim JH, Suh DS, Kim YM, Kim YT, et al. Laparoscopic-assisted vaginal hysterectomy versus abdominal hysterectomy in patients with stage I and II endometrial cancer. Int J Gynecol Cancer. 2005;15:932–7.PubMedCrossRef Kim DY, Kim MK, Kim JH, Suh DS, Kim YM, Kim YT, et al. Laparoscopic-assisted vaginal hysterectomy versus abdominal hysterectomy in patients with stage I and II endometrial cancer. Int J Gynecol Cancer. 2005;15:932–7.PubMedCrossRef
35.
Zurück zum Zitat Kornblith AB, Huang HQ, Walker JL, Spirtos NM, Rotmensch J, Cella D. Quality of life of patients with endometrial cancer undergoing laparoscopic international federation of gynecology and obstetrics staging compared with laparotomy: a Gynecologic Oncology Group study. J Clin Oncol. 2009;27:5337–42.PubMedCrossRef Kornblith AB, Huang HQ, Walker JL, Spirtos NM, Rotmensch J, Cella D. Quality of life of patients with endometrial cancer undergoing laparoscopic international federation of gynecology and obstetrics staging compared with laparotomy: a Gynecologic Oncology Group study. J Clin Oncol. 2009;27:5337–42.PubMedCrossRef
36.
Zurück zum Zitat Leiserowitz GS, Xing G, Parikh-Patel A, Cress R, Abidi A, Rodriguez AO, et al. Laparoscopic versus abdominal hysterectomy for endometrial cancer: comparison of patient outcomes. Int J Gynecol Cancer. 2009;19:1370–6.PubMedCrossRef Leiserowitz GS, Xing G, Parikh-Patel A, Cress R, Abidi A, Rodriguez AO, et al. Laparoscopic versus abdominal hysterectomy for endometrial cancer: comparison of patient outcomes. Int J Gynecol Cancer. 2009;19:1370–6.PubMedCrossRef
37.
Zurück zum Zitat Lim PC, Kang E, Park DH. A comparative detail analysis of the learning curve and surgical outcome for robotic hysterectomy with lymphadenectomy versus laparoscopic hysterectomy with lymphadenectomy in treatment of endometrial cancer: a case-matched controlled study of the first one hundred twenty two patients. Gynecol Oncol. 2011;120:413–8.PubMedCrossRef Lim PC, Kang E, Park DH. A comparative detail analysis of the learning curve and surgical outcome for robotic hysterectomy with lymphadenectomy versus laparoscopic hysterectomy with lymphadenectomy in treatment of endometrial cancer: a case-matched controlled study of the first one hundred twenty two patients. Gynecol Oncol. 2011;120:413–8.PubMedCrossRef
38.
Zurück zum Zitat Lim PC, Kang E, Park do H. Learning curve and surgical outcome for robotic-assisted hysterectomy with lymphadenectomy: case-matched controlled comparison with laparoscopy and laparotomy for treatment of endometrial cancer. J Minim Invasive Gynecol. 2010;17:739–48.PubMedCrossRef Lim PC, Kang E, Park do H. Learning curve and surgical outcome for robotic-assisted hysterectomy with lymphadenectomy: case-matched controlled comparison with laparoscopy and laparotomy for treatment of endometrial cancer. J Minim Invasive Gynecol. 2010;17:739–48.PubMedCrossRef
39.
Zurück zum Zitat Malzoni M, Tinelli R, Cosentino F, Perone C, Rasile M, Iuzzolino D, et al. Total laparoscopic hysterectomy versus abdominal hysterectomy with lymphadenectomy for early-stage endometrial cancer: a prospective randomized study. Gynecol Oncol. 2009;112:126–33.PubMedCrossRef Malzoni M, Tinelli R, Cosentino F, Perone C, Rasile M, Iuzzolino D, et al. Total laparoscopic hysterectomy versus abdominal hysterectomy with lymphadenectomy for early-stage endometrial cancer: a prospective randomized study. Gynecol Oncol. 2009;112:126–33.PubMedCrossRef
40.
Zurück zum Zitat Manolitsas TP, McCartney AJ. Total laparoscopic hysterectomy in the management of endometrial carcinoma. J Am Assoc Gynecol Laparosc. 2002;9:54–62.PubMedCrossRef Manolitsas TP, McCartney AJ. Total laparoscopic hysterectomy in the management of endometrial carcinoma. J Am Assoc Gynecol Laparosc. 2002;9:54–62.PubMedCrossRef
41.
Zurück zum Zitat Nezhat F, Yadav J, Rahaman J, Gretz H, Cohen C. Analysis of survival after laparoscopic management of endometrial cancer. J Minim Invasive Gynecol. 2008;15:181–7.PubMedCrossRef Nezhat F, Yadav J, Rahaman J, Gretz H, Cohen C. Analysis of survival after laparoscopic management of endometrial cancer. J Minim Invasive Gynecol. 2008;15:181–7.PubMedCrossRef
42.
Zurück zum Zitat Obermair A, Manolitsas TP, Leung Y, Hammond IG, McCartney AJ. Total laparoscopic hysterectomy for endometrial cancer: patterns of recurrence and survival. Gynecol Oncol. 2004;92:789–93.PubMedCrossRef Obermair A, Manolitsas TP, Leung Y, Hammond IG, McCartney AJ. Total laparoscopic hysterectomy for endometrial cancer: patterns of recurrence and survival. Gynecol Oncol. 2004;92:789–93.PubMedCrossRef
43.
Zurück zum Zitat Santi A, Kuhn A, Gyr T, Eberhard M, Johann S, Günthert AR, et al. Laparoscopy or laparotomy? A comparison of 240 patients with early-stage endometrial cancer. Surg Endosc. 2010;24:939–43.PubMedCrossRef Santi A, Kuhn A, Gyr T, Eberhard M, Johann S, Günthert AR, et al. Laparoscopy or laparotomy? A comparison of 240 patients with early-stage endometrial cancer. Surg Endosc. 2010;24:939–43.PubMedCrossRef
44.
Zurück zum Zitat Scribner DR Jr, Walker JL, Johnson GA, McMeekin SD, Gold MA, Mannel RS. Surgical management of early-stage endometrial cancer in the elderly: is laparoscopy feasible? Gynecol Oncol. 2001;83:563–8.PubMedCrossRef Scribner DR Jr, Walker JL, Johnson GA, McMeekin SD, Gold MA, Mannel RS. Surgical management of early-stage endometrial cancer in the elderly: is laparoscopy feasible? Gynecol Oncol. 2001;83:563–8.PubMedCrossRef
45.
Zurück zum Zitat Tozzi R, Malur S, Koehler C, Schneider A. Laparoscopy versus laparotomy in endometrial cancer: first analysis of survival of a randomized prospective study. J Minim Invasive Gynecol. 2005;12:130–6.PubMedCrossRef Tozzi R, Malur S, Koehler C, Schneider A. Laparoscopy versus laparotomy in endometrial cancer: first analysis of survival of a randomized prospective study. J Minim Invasive Gynecol. 2005;12:130–6.PubMedCrossRef
46.
Zurück zum Zitat Tozzi R, Malur S, Koehler C, Schneider A. Analysis of morbidity in patients with endometrial cancer: is there a commitment to offer laparoscopy? Gynecol Oncol. 2005;97:4–9.PubMedCrossRef Tozzi R, Malur S, Koehler C, Schneider A. Analysis of morbidity in patients with endometrial cancer: is there a commitment to offer laparoscopy? Gynecol Oncol. 2005;97:4–9.PubMedCrossRef
47.
Zurück zum Zitat Walker JL, Piedmonte MR, Spirtos NM, Eisenkop SM, Schlaerth JB, Mannel RS, et al. Laparoscopy compared with laparotomy for comprehensive surgical staging of uterine cancer: gynecologic Oncology Group Study LAP2. J Clin Oncol. 2009;27:5331–6.PubMedCrossRef Walker JL, Piedmonte MR, Spirtos NM, Eisenkop SM, Schlaerth JB, Mannel RS, et al. Laparoscopy compared with laparotomy for comprehensive surgical staging of uterine cancer: gynecologic Oncology Group Study LAP2. J Clin Oncol. 2009;27:5331–6.PubMedCrossRef
48.
Zurück zum Zitat Ghezzi F, Cromi A, Serati M, Uccella S, Formenti G, Bogani G, et al. Radiation-induced bowel complications: laparoscopic versus open staging of gynecologic malignancy. Ann Surg Oncol. 2011;18:782–91.PubMedCrossRef Ghezzi F, Cromi A, Serati M, Uccella S, Formenti G, Bogani G, et al. Radiation-induced bowel complications: laparoscopic versus open staging of gynecologic malignancy. Ann Surg Oncol. 2011;18:782–91.PubMedCrossRef
49.
Zurück zum Zitat Gutt CN, Oniu T, Schemmer P, Mehrabi A, Buchler MW. Fewer adhesions induced by laparoscopic surgery? Surg Endosc. 2004;18:898–906.PubMedCrossRef Gutt CN, Oniu T, Schemmer P, Mehrabi A, Buchler MW. Fewer adhesions induced by laparoscopic surgery? Surg Endosc. 2004;18:898–906.PubMedCrossRef
50.
Zurück zum Zitat Ott DE. Laparoscopy and adhesion formation, adhesions and laparoscopy. Semin Reprod Med. 2008;26:322–30.PubMedCrossRef Ott DE. Laparoscopy and adhesion formation, adhesions and laparoscopy. Semin Reprod Med. 2008;26:322–30.PubMedCrossRef
51.
Zurück zum Zitat Starling EH. Classics in lymphology. Lymphology. 1984;17:83–8. Starling EH. Classics in lymphology. Lymphology. 1984;17:83–8.
Metadaten
Titel
Lymphoceles, Lymphorrhea, and Lymphedema after Laparoscopic and Open Endometrial Cancer Staging
verfasst von
Fabio Ghezzi, MD
Stefano Uccella, MD
Antonella Cromi, PhD
Giorgio Bogani, MD
Claudio Robba, MD
Maurizio Serati, MD
Pierfrancesco Bolis, MD
Publikationsdatum
01.01.2012
Verlag
Springer-Verlag
Erschienen in
Annals of Surgical Oncology / Ausgabe 1/2012
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-011-1854-5

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Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.