WEINBERGER, Vít, Luboš MINÁŘ, Michal FELSINGER, Dagmar SEIDLOVÁ, Petra OVESNÁ, Markéta BEDNAŘÍKOVÁ, Eva JANDÁKOVÁ and Ivo ROVNÝ. Vliv pooperačního podání oktreotidu na redukci lymforey a následně vzniku lymfocyst, lymfedému a lymfatického ascitu po lymfadenektomii u gynekologických malignit (Postoperative administration of octreotide to reduce lymphorrhea, lymphocele, lymphedema and lymphatic ascites after lymphadenectomy in gynecological malignancies). Česká gynekologie. Praha: Nakladatelské a tiskové středisko ČLS JEP, 2017, vol. 82, No 2, p. 92-99. ISSN 1210-7832.
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Basic information
Original name Vliv pooperačního podání oktreotidu na redukci lymforey a následně vzniku lymfocyst, lymfedému a lymfatického ascitu po lymfadenektomii u gynekologických malignit
Name (in English) Postoperative administration of octreotide to reduce lymphorrhea, lymphocele, lymphedema and lymphatic ascites after lymphadenectomy in gynecological malignancies
Authors WEINBERGER, Vít (203 Czech Republic, guarantor, belonging to the institution), Luboš MINÁŘ (203 Czech Republic, belonging to the institution), Michal FELSINGER (203 Czech Republic, belonging to the institution), Dagmar SEIDLOVÁ (203 Czech Republic, belonging to the institution), Petra OVESNÁ (203 Czech Republic, belonging to the institution), Markéta BEDNAŘÍKOVÁ (203 Czech Republic, belonging to the institution), Eva JANDÁKOVÁ (203 Czech Republic, belonging to the institution) and Ivo ROVNÝ (203 Czech Republic, belonging to the institution).
Edition Česká gynekologie, Praha, Nakladatelské a tiskové středisko ČLS JEP, 2017, 1210-7832.
Other information
Original language Czech
Type of outcome Article in a journal
Field of Study 30214 Obstetrics and gynaecology
Country of publisher Czech Republic
Confidentiality degree is not subject to a state or trade secret
RIV identification code RIV/00216224:14110/17:00100148
Organization unit Faculty of Medicine
UT WoS 000403505200001
Keywords (in Czech) lymfadenektomie; lymfatický ascites; Iymfedém; lymfocysta; oktreotid
Keywords in English lymphadenectomy; lymphatic ascites; lymphedema; lymphocele; octreotide
Tags EL OK
Tags International impact, Reviewed
Changed by Changed by: Soňa Böhmová, učo 232884. Changed: 2/3/2018 17:03.
Abstract
Úvod: Oktreotid je syntetický analog somatostatinu. Vliv oktreotidu na redukci lymforey byl v onkogynekologii hodnocen dosud jen kazuísticky. Typ práce: Původní práce s vlastním souborem pacientek. Název a sídlo pracoviště: Gynekologicko-porodnická klinika LF MU a Fakultní nemocnice Brno, přednosta prof. MUDr. P. Ventruba, DrSc,, MBA. Metodika: Jedná se o prospektivní randomizovanou studii z roku 2014. Pacientky s karcinomem hrdla, těla dělohy a ovaria podstoupily v indikovaných případech pánevní a/nebo paraaortální lymfadenektomii. Oktreotid byl pacientkám podán po randomizaci a zařazení do skupiny s léčbou nebo bez léčby, podepsaly informovaný souhlas. Efekt oktreotidu byl hodnocen v souvislostí s diagnózou, operací (laparoskopíe versus laparotomie), pánevní a/nebo paraaortální lymfadenektomii, počtem odstraněných uzlin a jejich pozitivitou, krevní ztrátou a délkou operačního výkonu, celkovým počtem drénů zavedených do dutiny břišní, neoadjuvantnía adjuvantní chemoterapií, adjuvantní radioterapií, hladinou albuminu předoperačně, BMI, počtem dní s dřeném po operaci a počtem dní hospitalizace.
Abstract (in English)
Introduction: Octreotide is a synthetic analogue of natural somatostatin. Octreotide effect on lymphorrhea reduction in gynecological malignancies has only been assessed in case studies. Design: Original work. Setting: Gynecologic Oncology Center, Department of Obstetrics and Gynecology, Faculty of Medicine, Masaryk University and University Hospital Brno. Methods: In 2014 there was a prospective, randomized, one-institution study. Patients underwent surgery including pelvic or pelvic and paraaortic lymphadenectomy for cervical, uterine and ovarian cancer. The informed consent was signed. Octreotide was evaluated in relation to diagnosis, surgery (laparoscopy versus laparotomy), pelvic and/or paraaortic lymphadenectomy, number of removed lymph nodes and their positivity, neoadjuvant chemotherapy, adjuvant chemotherapy, adjuvant radiotherapy, albumin, BMI, number of days with drains postoperatively, number of days in hospital, blood loss during surgery, time of surgery, total number of drains placed into abdominal cavity. In follow up period, within 1 year after surgery, we searched for lymphocele, lymphedema of lower extremities and lymphatic ascites in relation to lymphorrhea. Results: 44 patients (9 cervical, 19 endometrial and 16 ovarian cancer) were enrolled in two statistically comparable randomized groups., Octreotide group", which paradoxically showed lymphorrhea of 4082 ml on average, (without 1992 ml, p = 0.001), needed drainage for more days (p = 0.001). The diagnosis had no influence on lymphorrhea in both groups (p = 0.966). The neoadjuvant chemotherapy was administered (p = 0.026), the more lymph nodes were removed (p = 0.018), the more days the drainage was in place (p < 0.001), the bigger the lymphorrhea; no relationship between lymphorrhea and age (p = 0.631), albumin level (p = 0.584), BMI (p = 0.966) or number of positive nodes (p = 0.259), length of surgery (p = 0.206), blood loss (p = 0.494). Nor lymphedema (p = 0.404), nor lymphocele (p = 0.086), correlated with postoperative lymphorrhea. Lymphatic ascites was associated with lymphorrhea (p = 0.048). Conclusion: Octreotide did not reduce lymphorrhea and the incidence of lymphocele, lymphedema of lower extremities and lymphatic ascites within one year of follow-up period after surgery. According to our results, we do not recommend to administer the octreotide in oncogynecological patients after pelvic and/or paraaortic lymphadenectomy.
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