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Risk factors for lymphorrhea and lymphocele after radical prostatectomy: a retrospective case–control study

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Abstract

Purpose

To investigate the risk factors for postoperative lymphorrhea or/and lymphocele (PLL) in patients undergoing radical prostatectomy (RP).

Materials and Methods

The clinical data of 606 patients were retrospectively collected. The receiver operating characteristic (ROC) curve was utilized to identify the optimal cutoff value. Multivariable logistic regression analysis was used to screen the independent predictors of PLL.

Results

Univariate analysis showed that nine factors differed between the PLL and non-PLL group. Multivariable logistic regression analysis showed that low preoperative fibrinogen level, extraperitoneal surgery, robot-assisted laparoscopic radical prostatectomy (RALRP), and hypoalbuminemia were risk factors and the use of fibrin glue was a protective factor. Correlation analysis showed that the scope of LN dissection (LND) and number of lymph nodes (LNs) dissected were positively correlated with PLL in the extraperitoneal approach, but were not significantly correlated with PLL in the transperitoneal approach. The use of fibrin glue was negatively associated with PLL in the overall procedure and the extraperitoneal approach, but not significantly so in the transperitoneal approach. Comparison of LNs clearance between the two surgical approaches revealed that the extent of LND and number of LNs dissected in the extraperitoneal approach were less than in the transperitoneal approach.

Conclusion

During RALRP, more attention should be paid to fully clotting the broken end of lymphatic vessels. The use of fibrin glue could reduce the probability of PLL. The extent of LND or number of LNs dissected were positively correlated with PLL in the extraperitoneal approach.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Author notes

  1. Wen-Cai Zheng, Zhi-Bin Ke, Yu-Peng Wu and Jia-Yin Chen contributed equally to this work.

Authors and Affiliations

  1. Department of Urology, Urology Research Institute, The First Affiliated Hospital, Fujian Medical University, 20 Chazhong Road, Fuzhou, 350005, China

    Wen-Cai Zheng, Zhi-Bin Ke, Yu-Peng Wu, Jia-Yin Chen, Shao-Hao Chen, Qing-Shui Zheng, Yong Wei, Xiong-Lin Sun, Xue-Yi Xue, Xiao-Dong Li & Ning Xu

  2. Fujian Key Laboratory of Precision Medicine for Cancer, The First Affiliated Hospital, Fujian Medical University, 20 Chazhong Road, Fuzhou, 350005, China

    Xue-Yi Xue & Ning Xu

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  1. Wen-Cai Zheng
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345_2023_4321_MOESM3_ESM.tif

Supplementary file3 Supplement Figure 1. The ROC of preoperative fibrinogen on different surgical approaches. (TIF 377 kb)

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Zheng, WC., Ke, ZB., Wu, YP. et al. Risk factors for lymphorrhea and lymphocele after radical prostatectomy: a retrospective case–control study. World J Urol 41, 1033–1039 (2023). https://doi.org/10.1007/s00345-023-04321-2

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