{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T16:40:35Z","timestamp":1775320835957,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,6,9]],"date-time":"2021-06-09T00:00:00Z","timestamp":1623196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To reduce the risk of symptomatic lymphocele (SLC), we present a technique using peritoneal fenestration that allows lymphatic fluid to drain into the abdomen, as SLC formation after open retropubic radical prostatectomy (ORP) with pelvic lymph node dissection (PLND) is a common adverse event.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>We identified 1513 patients who underwent ORP with PLND between July 2018 and November 2019. Of those, 307 patients (20.3%) received peritoneal fenestration and 1206 (79.7%) no fenestration. The rate of LCs and the necessity for intervention were analysed by uni\u2010 and multivariable logistic regression (MLR) models. A propensity score matching was performed, as well.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median (interquartile range [IQR]) age was 65\u00a0(60\u201370)\u00a0years. A median (IQR) of 16\u00a0(10\u201322) lymph nodes were dissected, 22 vs 14 lymph nodes in the fenestration vs non\u2010fenestration group (\n                      <jats:italic>P\u00a0<\/jats:italic>\n                      &lt;\u00a00.001). Overall, 189 patients (12.5%) were diagnosed with a LC after ORP, while 21 patients (6.8%) in the fenestration and 168 (13.9%) in the non\u2010fenestration group had LCs (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.001). In 70 patients (4.7%), LCs required further intervention, categorised as Clavien\u2013Dindo Grade IIIa\/b, with a smaller proportion in the fenestration group (2.9% vs 5.0% in the non\u2010fenestration group,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). There were no Clavien\u2013Dindo Grade IV or V complications, in particular no abdominal complications in association with peritoneal fenestration observed. In MLR, peritoneal fenestration was associated with a reduced risk of LCs (odds ratio [OR] 0.33, 95% confidence interval [CI] 0.2\u20130.5;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). The risk reduction was also shown after propensity score matching (OR 0.38, 95% CI 0.21\u20130.68;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.001). The number needed to treat was 14.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Peritoneal fenestration may decrease the rate of SLC after ORP with (extended) PLND. Therefore, it should be part of the operative strategy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.15497","type":"journal-article","created":{"date-parts":[[2021,5,26]],"date-time":"2021-05-26T04:35:30Z","timestamp":1622003730000},"page":"728-733","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Significant reduction of lymphoceles after radical prostatectomy and pelvic lymph node dissection"],"prefix":"10.1111","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7818-8125","authenticated-orcid":false,"given":"Randi M.","family":"Pose","sequence":"first","affiliation":[{"name":"Martini\u2010Klinik Prostate Cancer Centre University Hospital Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2681-3611","authenticated-orcid":false,"given":"Sophie","family":"Knipper","sequence":"additional","affiliation":[{"name":"Martini\u2010Klinik Prostate Cancer Centre University Hospital Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"W\u00fcrnschimmel","sequence":"additional","affiliation":[{"name":"Martini\u2010Klinik Prostate Cancer Centre University Hospital Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9237-3442","authenticated-orcid":false,"given":"Pierre","family":"Tennstedt","sequence":"additional","affiliation":[{"name":"Martini\u2010Klinik Prostate Cancer Centre University Hospital Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uwe","family":"Michl","sequence":"additional","affiliation":[{"name":"Martini\u2010Klinik Prostate Cancer Centre University Hospital Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tobias","family":"Maurer","sequence":"additional","affiliation":[{"name":"Martini\u2010Klinik Prostate Cancer Centre University Hospital Hamburg\u2010Eppendorf Hamburg Germany"},{"name":"Department of Urology University Hospital Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus","family":"Graefen","sequence":"additional","affiliation":[{"name":"Martini\u2010Klinik Prostate Cancer Centre University Hospital Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Steuber","sequence":"additional","affiliation":[{"name":"Martini\u2010Klinik Prostate Cancer Centre University Hospital Hamburg\u2010Eppendorf Hamburg Germany"},{"name":"Department of Urology University Hospital Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,6,9]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"MottetN CornfordP van denBerghRet\u00a0al.members of the EAU \u2013 ESTRO \u2013 ESUR \u2013SIOG Prostate Cancer Guidelines Panel. 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