Evaluating the importance of routine drainage following laparoscopic pelvic lymph node dissection for gynecological malignancies.

Objective To determine the efficacy of drainage following pelvic lymph node dissection (PLN), especially for cases involving laparoscopic surgery. Methods In this retrospective study, 368 patients with malignant gynecological tumors who underwent systemic PLN at Keio University Hospital between January 2012 and October 2018 were enrolled. Drainage tubes were placed in the retroperitoneal fossa in all patients. Medical records were used for data collection. Results Laparoscopy was performed on 81 patients, and laparotomy was performed on 287 patients. In the laparoscopy group, tubes were removed 1 day postsurgery. In the laparotomy group, tubes were removed 1 day postsurgery in 167 patients and 4 days postsurgery in 120 patients. Compared with the laparotomy group, we determined the laparoscopy group to have a significantly lower prevalence of lymphocyst (6.2% vs 20.2%, P = 0.002) but a similar prevalence of lymphedema (4.9% vs 5.2%) and symptomatic lymphocyst (2.5% vs 4.5%). The groups were noted to not differ significantly with respect to the prevalence of lymphedema (4.8% vs 5.8%), lymphocyst (20.4% vs 20.0%), or symptomatic lymphocyst (4.2% vs 5.0%). Conclusion Our results suggest that routine drainage should be omitted, especially in cases involving laparoscopic surgery.