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SENTINEL NODE IN CERVICAL CANCER: PILOT STUDY

Background: The aim of the study was to estimate the influence of non-peritonisation technique for the lymphocysts formation in patients treated surgically for the cervical cancer. Material and Methods: The clinical material consists of 377 patients treated surgically in our hospital because of cervical cancer in the years 1996—2001. The patients were divided into groups regarding the proceeding with the pelvic peritoneum. Group I — 293 women operated with peritonisation (years 1996—2000) Group II — 84 women operated with non-peritonisation technique (year 2001) Symptomatic lymphocysts were diagnosed during control gynecological examination and confirmed with the ultrasound examination Results: In the group I we found 12 patients with symptomatic lymphocysts (4,1%), which necessitated punctures. In 3 cases lymphocysts caused occlusion of the external iliac vein. The average number of punctures was 2,8 (from 1 to 13). The contents of lymphcysts were sent to the bacteriological and pathological examination — we have found no neoplasmatic cells in any case. In the group II we did not observe any symptomatic lymphocysts. Discussion: Leaving the peritoneum open after pelvic lymph nodes dissection allows resorption of leaking lymph in the peritoneal cavity. The possible complication caused by unsutured peritoneum is incarceration of the intestinal loop or adhesions formations leading to ileus. In our material there were no intestinal complications in patients who did not have reapproximated pelvic peritoneum. Conclusions: Open pelvic peritoneum after lymph node dissection diminishes the risk of lymphocysts formation and should be a standard procedure in the radical gynecologic surgery.