Post‐operative incidence of lymphedema after RARP with or without extended pelvic lymph node dissection in a cohort study
Abstract Objectives Lymphedema of the lower limbs and pubic area is a potential complication following extended pelvic lymph node dissection (ePLND) during robot‐assisted radical prostatectomy (RARP). The incidence of lymphedema after ePLND has not been systematically reported in the literature. Thi...
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Wiley
2025-01-01
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| Series: | BJUI Compass |
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| Online Access: | https://doi.org/10.1002/bco2.466 |
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| author | Andries Clinckaert Laura Ysenbaardt Annabel Bijnens Charlotte Van Calster Inge Geraerts Steven Joniau Nele Devoogdt Luc Bijnens Wouter Everaerts |
| author_facet | Andries Clinckaert Laura Ysenbaardt Annabel Bijnens Charlotte Van Calster Inge Geraerts Steven Joniau Nele Devoogdt Luc Bijnens Wouter Everaerts |
| author_sort | Andries Clinckaert |
| collection | DOAJ |
| description | Abstract Objectives Lymphedema of the lower limbs and pubic area is a potential complication following extended pelvic lymph node dissection (ePLND) during robot‐assisted radical prostatectomy (RARP). The incidence of lymphedema after ePLND has not been systematically reported in the literature. This study aimed to determine the incidence of lymphedema, describe its clinical characteristics and identify specific risk factors in patients undergoing RARP with or without ePLND. Methods A retrospective cohort study was conducted at a tertiary referral centre between April 2016 and July 2020. Structured electronic case report forms (eCRFs) integrated into the electronic health record system were used to document intraoperative, perioperative and postoperative data. The primary endpoint was the incidence of lymphedema. Secondary endpoints included risk factors for and localization of the postoperative lymphedema. Results A total of 500 patients who underwent RARP were included, with 301 patients undergoing ePLND and 199 patients without any form of PLND. Median follow‐up period was 18 (range 3–49) months. Seventy‐eight out of 301 (26%) of patients who underwent ePLND developed lymphedema, compared to only 2 out of 199 (1%) patients without ePLND. In most patients (49/301, 16%), lymphedema was mild (grade 1), whereas 29 patients (10%) developed grade 2 lymphedema. Twenty‐six patients (9%) received decongestive lymphatic therapy. The most frequent site of lymphedema occurrence were the lower (54%) and the upper legs (40%). The number of nodes removed during RARP was identified as a risk factor for post‐operative lymphedema (OR 1.04; p < 0.05). Conclusions In this cohort study, approximately one in four patients undergoing RARP with ePLND developed lower limb and/or midline oedema, whereas one in ten patients started decongestive lymphatic therapy for symptomatic lymphedema. These findings provide valuable information for patient counselling about the potential benefits and risks of ePLND. |
| format | Article |
| id | doaj-art-3a54c6f273364a1d8da93d7e0cc5b241 |
| institution | Kabale University |
| issn | 2688-4526 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | BJUI Compass |
| spelling | doaj-art-3a54c6f273364a1d8da93d7e0cc5b2412025-01-31T00:14:32ZengWileyBJUI Compass2688-45262025-01-0161n/an/a10.1002/bco2.466Post‐operative incidence of lymphedema after RARP with or without extended pelvic lymph node dissection in a cohort studyAndries Clinckaert0Laura Ysenbaardt1Annabel Bijnens2Charlotte Van Calster3Inge Geraerts4Steven Joniau5Nele Devoogdt6Luc Bijnens7Wouter Everaerts8Department of Cellular and Molecular Medicine KU Leuven Leuven BelgiumDepartment of Urology University Hospitals of Leuven Leuven BelgiumDepartment of Urology University Hospitals of Leuven Leuven BelgiumDepartment of Rehabilitation Sciences University of Leuven Leuven BelgiumDepartment of Rehabilitation Sciences University of Leuven Leuven BelgiumDepartment of Urology University Hospitals of Leuven Leuven BelgiumDepartment of Rehabilitation Sciences University of Leuven Leuven BelgiumData science institute UHasselt Hasselt BelgiumDepartment of Cellular and Molecular Medicine KU Leuven Leuven BelgiumAbstract Objectives Lymphedema of the lower limbs and pubic area is a potential complication following extended pelvic lymph node dissection (ePLND) during robot‐assisted radical prostatectomy (RARP). The incidence of lymphedema after ePLND has not been systematically reported in the literature. This study aimed to determine the incidence of lymphedema, describe its clinical characteristics and identify specific risk factors in patients undergoing RARP with or without ePLND. Methods A retrospective cohort study was conducted at a tertiary referral centre between April 2016 and July 2020. Structured electronic case report forms (eCRFs) integrated into the electronic health record system were used to document intraoperative, perioperative and postoperative data. The primary endpoint was the incidence of lymphedema. Secondary endpoints included risk factors for and localization of the postoperative lymphedema. Results A total of 500 patients who underwent RARP were included, with 301 patients undergoing ePLND and 199 patients without any form of PLND. Median follow‐up period was 18 (range 3–49) months. Seventy‐eight out of 301 (26%) of patients who underwent ePLND developed lymphedema, compared to only 2 out of 199 (1%) patients without ePLND. In most patients (49/301, 16%), lymphedema was mild (grade 1), whereas 29 patients (10%) developed grade 2 lymphedema. Twenty‐six patients (9%) received decongestive lymphatic therapy. The most frequent site of lymphedema occurrence were the lower (54%) and the upper legs (40%). The number of nodes removed during RARP was identified as a risk factor for post‐operative lymphedema (OR 1.04; p < 0.05). Conclusions In this cohort study, approximately one in four patients undergoing RARP with ePLND developed lower limb and/or midline oedema, whereas one in ten patients started decongestive lymphatic therapy for symptomatic lymphedema. These findings provide valuable information for patient counselling about the potential benefits and risks of ePLND.https://doi.org/10.1002/bco2.466extended pelvic lymph node dissectionlymphedemarobot‐assisted radical prostatectomy |
| spellingShingle | Andries Clinckaert Laura Ysenbaardt Annabel Bijnens Charlotte Van Calster Inge Geraerts Steven Joniau Nele Devoogdt Luc Bijnens Wouter Everaerts Post‐operative incidence of lymphedema after RARP with or without extended pelvic lymph node dissection in a cohort study BJUI Compass extended pelvic lymph node dissection lymphedema robot‐assisted radical prostatectomy |
| title | Post‐operative incidence of lymphedema after RARP with or without extended pelvic lymph node dissection in a cohort study |
| title_full | Post‐operative incidence of lymphedema after RARP with or without extended pelvic lymph node dissection in a cohort study |
| title_fullStr | Post‐operative incidence of lymphedema after RARP with or without extended pelvic lymph node dissection in a cohort study |
| title_full_unstemmed | Post‐operative incidence of lymphedema after RARP with or without extended pelvic lymph node dissection in a cohort study |
| title_short | Post‐operative incidence of lymphedema after RARP with or without extended pelvic lymph node dissection in a cohort study |
| title_sort | post operative incidence of lymphedema after rarp with or without extended pelvic lymph node dissection in a cohort study |
| topic | extended pelvic lymph node dissection lymphedema robot‐assisted radical prostatectomy |
| url | https://doi.org/10.1002/bco2.466 |
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