[Delay of the formation of retroperitoneal fibrosis after lymphadenectomy. An experimental study]. / Délai de formation de la fibrose rétropéritonéale après lymphadénectomie. Etude expérimentale.

The goal of our study was to evaluate peritoneal and retroperitoneal healing and therefore to assess the optimal date for surgery after laparoscopic lymphadenectomy. A para-aortic lymphadenectomy was carried out in 5 groups of 5 New Zealand female rabbits. The perivascular cicatricial tissue was dissected after specific delay for each group (48 hours, 1 week, 2 weeks, 4 weeks, and 6 weeks). Peritoneal reconstruction was observed in 80% of the "48 h" group, and in 100% in the other groups (from 1 to 6 weeks). Vascular injury complicated dissection in 40% for the "1 week" group, in 80% for the "2 weeks" group, and in 20% for the "6 weeks" group. No vascular complication was observed in the "48 h" and "4 weeks" groups. The results of "1 week" and "2 weeks" were combined. The results of the "4 weeks" group were compared, with the Fisher test, to the results of a "1 week" and "2 weeks" combined group as well as to the results of the "six weeks" group. Four weeks seem to be the optimal date for a possible surgical excision after a laparoscopic lymphadenectomy.

The long-term follow-up of idiopathic retroperitoneal fibrosis.

In a series of patients with idiopathic retroperitoneal fibrosis followed for up to 22 years, 21 were treated after ureterolysis of 36 ureters by wrapping the ureters in omentum. Recurrent fibrosis was noted in 2 patients involving 2 ureters. Earlier in the same period 3 patients with 4 ureters were treated by intraperitoneal placement after ureterolysis: in these, recurrence was noted in 2 patients involving 2 ureters. Steroids were used as an adjuvant when ureterolysis was incomplete or for relapse. The omentum appears to afford long-term protection against return of the fibrosis around the ureter.