Effective management of pelvic lymphocysts by laparoscopic marsupialization

Fo, Recio; Ghamande, Shekhar; Re, Hempling; Piver,

doi:10.1016/s1074-3804(99)80281-3

Cited by 3 publications

(3 citation statements)

References 7 publications

(10 reference statements)

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“…58,85 Laparoscopic management was then developed, which also entailed marsupialization into the peritoneum, with reduced procedure time and patient morbidity. 86 Interventional radiology has also been involved in the management of lymphoceles. Percutaneous aspiration under image guidance was reported, but given the high recurrence rate, this approach has strictly a diagnostic role.…”

Section: Diagnosismentioning

confidence: 99%

Chylous Ascites and Lymphoceles: Evaluation and Interventions

Santos

Moussa

2020

Semin intervent Radiol

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Kinmonth introduced lymphangiography in 1955 and it became an important tool in the diagnosis and treatment of malignant disease. The technique, based on bipedal approach, was difficult and time-consuming which limited its use in clinical practice. Cope is the father of percutaneous lymphatic interventions and he was the first person to access and intervene on the lymphatic system. After his initial work published on 1999, there has been an expansion of the lymphatic embolization techniques, particularly since the development of intranodal lymphangiography and advance lymphatic imaging. This article is focused on the evaluation and management of postoperative chylous ascites and lymphoceles. Their incidence is growing due to longer survival of cancer patients and more radical surgical approaches, leading to an increased morbidity and mortality in this patient population. Minimally invasive percutaneous lymphatic embolization is becoming a first-line therapy in patients with postoperative lymphatic leakage.

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Section: Diagnosismentioning

confidence: 99%

Chylous Ascites and Lymphoceles: Evaluation and Interventions

Santos

Moussa

2020

Semin intervent Radiol

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“…The management of lymphoceles has involved several strategies, including percutaneous ultrasound-guided drainage with or without sclerotherapy, open drainage or marsupialization by laparotomy or laparoscopy [10,11].…”

Section: Introductionmentioning

confidence: 99%

Robot-assisted removal of a lymphocyst causing severe neuralgic pain and adductor atrophy

et al. 2011

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Following a robot-assisted radical hysterectomy and pelvic lymphadenectomy for early-stage cervical cancer, a 53-year-old woman was diagnosed with a 50-mm right-sided pelvic lymphocyst by the use of vaginal ultrasonography. She gradually developed intermittent increasingly severe neuralgic pain mimicking a meralgia paresthetica. A neurolysis was proposed by the neurosurgeons. Awaiting this intervention, a pelvic MRI revealed a partial atrophy of the ipsilateral adductor muscles and a probable entrapment of the obturator nerve by the lymphocyst as an alternative cause of the pain. Using a four-arm da Vinci-S-HD robot the lymphocyst, located deep in the right obturator fossa and surrounding the obturator nerve, was completely removed, sparing the partially atrophic obturator nerve. No bleeding occurred. The surgery time was 95 min. At 10 months' follow-up the patient was relieved of her pain with no signs of a new lymphocyst.

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“…These can be surgical or nonsurgical. The most frequently used surgical method is laparoscopy with fenestration or marsupialization of the lymphocyst [13][14][15] . Nonsurgical approaches include using ultrasound-or CT-guided drainage with or without sclerosing agent instillation [2][3][4][16][17][18][19][20][21] .…”

Section: Introductionmentioning

confidence: 99%

Management of Pelvic Lymphocysts by Ultrasound-Guided Aspiration and Minocycline Sclerotherapy

Liu

Hung

Hwang

et al. 2005

Gynecol Obstet Invest

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Objective: The purpose of this study was to describe our experience with ultrasound-guided aspiration of postoperative pelvic lymphocysts followed by intracavitary minocycline injection as sclerotherapy. Patients and Methods: From 1997 to 2003, patients who developed either symptomatic or persistent lymphocyst after pelvic lymphadenectomy for gynecological malignancy were recruited in this study. All of the lymphocysts were palpable and were further examined by ultrasonography. Percutaneous ultrasound-guided needle aspiration of the lymphocyst was performed and then immediately followed by a single-dose injection of minocycline into the collapsed cavity. Follow-up was conducted every 4 weeks with pelvic examination and ultrasonography. Results: Nineteen patients with a total of 21 pelvic lymphocysts underwent this procedure. The median size of the lymphocysts was 6 cm in diameter (range, 4–9 cm). Fifteen patients received 1 treatment, 3 received 2, and 1 patient with bilateral lymphocysts received 3 treatments. Complete resolution occurred in 14 patients (74%), and the other 5 patients (26%) had partial resolution with the volume of the lymphocyst decreasing at least 50%. For the 14 patients with complete resolution, the median time from treatment to disappearance of the lymphocyst was 3 months (range, 1–10 months), and none of them developed recurrence during the average follow-up period of 40 months (range, 2–62 months). No significant complication occurred with this procedure except for transient mild to moderate pelvic pain. Discussion: Minocycline sclerotherapy seems to be a simple and safe method with a satisfactory success rate in treating lymphocysts which develop after pelvic lymphadenectomy. It can be performed in an outpatient setting and can be repeated if necessary. This procedure may be considered as the initial treatment modality for patients suffering from symptomatic or persistent lymphocysts after radical gynecological surgery.

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Effective management of pelvic lymphocysts by laparoscopic marsupialization

Cited by 3 publications

References 7 publications

Chylous Ascites and Lymphoceles: Evaluation and Interventions

Chylous Ascites and Lymphoceles: Evaluation and Interventions

Robot-assisted removal of a lymphocyst causing severe neuralgic pain and adductor atrophy

Management of Pelvic Lymphocysts by Ultrasound-Guided Aspiration and Minocycline Sclerotherapy

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