The achilles heel of minimally invasive inguinal lymph node dissection: Seroma formation.

OBJECTIVE

To describe the incidence of post-operative seroma and interventions attempted to reduce this complication in patients undergoing minimally invasive inguinal lymph node dissection (MILND).

BACKGROUND

MILND has resulted in fewer wound complications, hospital readmissions, and shorter length of stay; unfortunately, seroma formation remains a major source of morbidity.

METHODS

A retrospective study of MILNDs performed from 2010 to 2017 was conducted. Different interventions were trialed attempting to combat this problem. We report the analysis with respect to seroma formation.

RESULTS

Forty-one patients underwent 44 MILND. Twenty-two (50%) patients developed symptomatic seroma requiring aspiration and/or drain placement. Risk factors associated with seroma on univariate analysis were increased number of metastatic nodes (p = 0.028), increasing BMI (p = 0.046), increasing age (p = 0.056), and larger suction drain bulbs (p = 0.013). There was an association with postoperative seroma formation and post-operative lymphedema (p = 0.001). Multiple interventions trialed to reduce seroma formation were unsuccessful in reducing the seroma rate.

CONCLUSION

Seromas formation continues to be a common morbidity following MILND. Further research is needed to determine how seroma incidence can be reduced in patients undergoing MILND.