Modified Laparoscopic Lymphocele Marsupialization for the Treatment of Lymphoceles After Radical Prostatectomy: First Results

Abstract

The objective of this study was to describe a simple modification of the laparoscopic pelvic lymphocele marsupialization (LL) following radical prostatectomy lymphoceles (RP-LC). Forty-eight patients (57-76 years) with symptomatic RP-LC underwent surgery in our institute. This was through an open approach in 6 (open drainage [OL]) and LL in rest of the patients (12 with 3 [LL3] and 30 with 2 [LL2] trocars). All except 2 patients were refractory to percutaneous tube drainage and/or sclerotherapy. Pelvic ultrasound and/or computed tomography scans revealed LC size (4 × 5-11 × 12 cm) and volumes (100-1100 mL). All surgeries were uneventful with an operative time of 15-60 minutes for LL and 35-90 minutes for OL and it became shorter with increasing experience with LL2 (15-25 minutes). Mean hospitalization time was 2.3 and 8 days after LL (LL2 and LL3) and OL, respectively. LC were at the right side in 10 patients, at the left side in 6, and at both sides in 14. Postoperative ultrasound revealed primary success in all cases. No patient developed recurrence of or had treatment for lymphocele during a mean follow-up time of 19 months. LL2 is a simple, feasible, and safe procedure that could be used as a first-line treatment for large, noninfected symptomatic or refractive RP-LC.