Doppler evaluation of external iliac vein hemodynamic changes caused by lymphocele after lymphadenectomy for cervical cancer
✍ Scribed by Agnieszka Bianek-Bodzak; Wojciech Sliwinski; Piotr Mielcarek
- Publisher
- John Wiley and Sons
- Year
- 2006
- Tongue
- English
- Weight
- 292 KB
- Volume
- 34
- Category
- Article
- ISSN
- 0091-2751
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✦ Synopsis
Purpose. To use Doppler sonography to assess the hemodynamic changes in the external iliac vein (EIV) compressed by a pelvic lymphocele after pelvic lymphadenectomy in patients with cervical cancer.
Materials and Methods. Postoperative gray-scale and Doppler sonographic examinations were performed in 71 women after pelvic lymphadenectomy. Twenty healthy women served as controls. When present, the lymphocele was graded on a scale of 1 to 4 based on the percentage of the circumference of iliac vessels in contact with the lymphocele (ie, circumferential contiguity) (grade 1, 0-24%; grade 2, 25-49%; grade 3, 50-74%; grade 4, 75-100%), and in 3 groups according to its maximum diameter (group A, 1-40 mm; group B, 41-60 mm; group C, >60 mm). EIV velocity was measured, and waveform modulation by respiratory movements was analyzed.
Results. There were 40 lymphoceles in 22 patients. The mean (6SD) EIV velocity was 24.5 6 14.8 cm/s in the control group, 38.2 6 5.9 cm/s in group 1, 69.2 6 29.4 cm/s in group 2, 105.75 6 12.36 cm/s in group 3, and 139.5 6 33.79 cm/s in group 4. Spontaneous EIV blood flow could not be detected in 2 cases in the later group. EIV flow modulation was significantly lower in patients with greater lymphocele contiguity or diameter.
Conclusions. Post-pelvic lymphadenectomy causes EIV extrinsic compression that results in upstream blood stasis, potentially increasing the risk for deep vein thrombosis. V