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Preventing Lymphedema and Morbidity With an Omentum Flap After Ilioinguinal Lymph Node Dissection

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Abstract

Background

Pedicled omentoplasty has been advocated to prevent the formation of lymphocysts and lymphedema after pelvic lymph node dissection, We evaluated the possible benefit of a pediculated omentoplasty placed in the groin for preventing complications after ilioinguinal lymph node dissection.

Methods

In this pilot study, we report a series of four women and three men with inguinal metastatic lymph nodes. Each was treated with a pediculated omentoplasty after groin dissection. We examined complications such as lymphedema, lymphorrhea, wound breakdown, skin necrosis, and lymphocysts.

Results

Only one wound breakdown with skin necrosis was observed, and it healed satisfactorily in 10 days without exposing the femoral vessels. No lymphocele or infectious complications occurred, even though no antibiotic prophylaxis was used. Midthigh circumference increase ranged from 1.5 to 7 cm in four cases but remained asymptomatic. Furthemaore, lymphedema of the lower limb decreased in the three remaining patients, who previously had an enlargement of the thigh. No evidence of peritoneal carcinomatosis was noted during the 4-month follow-up.

Conclusions

Pedicled omentoplasty seemed to facilitate the absorption or transport of lymph fluids and resulted in less lymphedema in the lower limb even after radiotherapy. Pedicled omentoplasty reduces both short-term and long-term postoperative complications without affecting treatment outcome and could even be considered as a safe and effective therapy for lymphedema of the lower extremity.

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Authors and Affiliations

  1. Service de Chirurgie Digestive, Thoracique, et Cancérologique, CHU du Bocage, B.P. 77908, 21079, Dijon Cedex, France

    Laurent Benoit MD & Nicolas Cheynel MD

  2. Service de Chirurgie, Centre G-F Leclerc, 1 Rue du Pr Marion, B.P. 77980, 21079, Dijon Cedex, France

    Laurent Benoit MD, Jean Cuisenier MD & Jean Fraisse MD

  3. Service de Médecine Nucléaire, Centre G-F Leclerc, 1 Rue du Pr Marion, B.P. 77980, 21079, Dijon Cedex, France

    Christophe Boichot MD

  4. Laboratoire d’Anatomopathologie, Centre G-F Leclerc, 1 Rue du Pr Marion, B.P. 77980, 21079, Dijon Cedex, France

    Laurent Arnould MD

  5. Service d’Oncologie Médicale, Centre G-F Leclerc, 1 Rue du Pr Marion , B.P. 77980, 21079, Dijon Cedex, France

    Bruno Chauffert MD

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  1. Laurent Benoit MD
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  2. Christophe Boichot MD
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  4. Laurent Arnould MD
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Correspondence to Laurent Benoit MD.

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Benoit, L., Boichot, C., Cheynel, N. et al. Preventing Lymphedema and Morbidity With an Omentum Flap After Ilioinguinal Lymph Node Dissection. Ann Surg Oncol 12, 793–799 (2005). https://doi.org/10.1245/ASO.2005.09.022

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  • DOI: https://doi.org/10.1245/ASO.2005.09.022

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