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10.1245/ASO.2005.09.022
Annals of Surgical Oncology 12:793-799 (2005)
© 2005 Society of Surgical Oncology
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Original Article

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

Laurent Benoit, MD1,2, Christophe Boichot, MD3, Nicolas Cheynel, MD1, Laurent Arnould, MD4, Bruno Chauffert, MD5, Jean Cuisenier, MD2 and Jean Fraisse, MD2

1 Service de Chirurgie Digestive, Thoracique, et Cancérologique, CHU du Bocage, B.P. 77908, 21079 Dijon Cedex, France
2 Service de Chirurgie, Centre G-F Leclerc, 1 Rue du Pr Marion, B.P. 77980, 21079 Dijon Cedex, France
3 Service de Médecine Nucléaire, Centre G-F Leclerc, 1 Rue du Pr Marion, B.P. 77980, 21079 Dijon Cedex, France
4 Laboratoire d’Anatomopathologie, Centre G-F Leclerc, 1 Rue du Pr Marion, B.P. 77980, 21079 Dijon Cedex, France
5 Service d’Oncologie Médicale, Centre G-F Leclerc, 1 Rue du Pr Marion, B.P. 77980, 21079 Dijon Cedex, France

Correspondence: Address correspondence and reprint requests to: Laurent Benoit, MD; E-mail: laurent.benoit{at}chu-dijon.fr

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.

Key Words: Radical inguinal lymphadenectomy • Lymphedema • Prevention • Omentoplasty • Complications






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