Khirurgiia · 2026
[Prevention of lymphorrhea after inguinal lymphadenectomy: a systematic review and meta-analysis].
СтатьяСистематический обзорМетаанализАннотация на английскомНазвание и аннотация: Перевод в очереди
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Bashirov S R, Barashkova A A, Vasilyeva E A, Garkusha V M, Arzhanik M B
Аннотация
OBJECTIVE: A systematic review and meta-analysis of methods for preventing lymphorrhea and lymphedema of limbs after inguinal lymphadenectomy.
MATERIAL AND METHODS: We reviewed the PubMed and Google Scholar databases in accordance with the PRISMA guidelines. Statistical analysis was performed using the MedCalc Version 18.9.1.
RESULTS: Among minimally invasive techniques, endoscopic single-site lymphadenectomy showed a 2-fold decrease in the incidence of lymphorrhea (8.53% (0.01 - 32.03%) versus 16.53% (9.92 - 24.42%)) and 9-fold decrease in lymphedema (1.96% (0.27 - 10.67%) versus 17.92% (10.55 - 26.73%)) compared to open inguinal lymph node dissection. Other modifications including myofascial flaps and preservation of the great saphenous vein demonstrated higher number of patients with lymphorrhea (23.71% (12.36 - 37.39%) and 29.23% (12.03 - 50.23%) and lymphedema (17.79% (6.49 - 33.14%) and 23.54% (10.68 - 41.86%), respectively). Reconstructive super-microsurgery methods, in particular lymphovenular anastomoses, decreased the incidence of lymphorrhea to 4.44% (0.52 - 15.32%) and lymphedema to 12.50% (0.32 - 38.17%).
CONCLUSION: Results of endoscopic procedures and various flaps were comparable to those after open lymph node dissection. At first glance, reconstructive microsurgery methods appeared to be very effective, but meta-analysis showed no significantly lower incidence of complications. In addition, their application is rather limited due to high cost and technical complexity. Thus, searching for effective methods for preventing lymphorrhea is important.
MATERIAL AND METHODS: We reviewed the PubMed and Google Scholar databases in accordance with the PRISMA guidelines. Statistical analysis was performed using the MedCalc Version 18.9.1.
RESULTS: Among minimally invasive techniques, endoscopic single-site lymphadenectomy showed a 2-fold decrease in the incidence of lymphorrhea (8.53% (0.01 - 32.03%) versus 16.53% (9.92 - 24.42%)) and 9-fold decrease in lymphedema (1.96% (0.27 - 10.67%) versus 17.92% (10.55 - 26.73%)) compared to open inguinal lymph node dissection. Other modifications including myofascial flaps and preservation of the great saphenous vein demonstrated higher number of patients with lymphorrhea (23.71% (12.36 - 37.39%) and 29.23% (12.03 - 50.23%) and lymphedema (17.79% (6.49 - 33.14%) and 23.54% (10.68 - 41.86%), respectively). Reconstructive super-microsurgery methods, in particular lymphovenular anastomoses, decreased the incidence of lymphorrhea to 4.44% (0.52 - 15.32%) and lymphedema to 12.50% (0.32 - 38.17%).
CONCLUSION: Results of endoscopic procedures and various flaps were comparable to those after open lymph node dissection. At first glance, reconstructive microsurgery methods appeared to be very effective, but meta-analysis showed no significantly lower incidence of complications. In addition, their application is rather limited due to high cost and technical complexity. Thus, searching for effective methods for preventing lymphorrhea is important.