ExpEriEncE of combinEd (with roEntgEnothErapy)   trEatmEnt of lymphorrhEa in thE groin aftEr   artErial rEconstruction

Kamalov, I. I.; Gоulyayeva, Inna V.; aKhmadeyev, Rustem R.

doi:10.20969/vskm.2010.3(3).50-51

Cited by 2 publications

(5 citation statements)

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“…Our data is consistent with what reported by Graz, Kazan and Zaporozhy. Low fraction doses of 0.3-0.5 Gy do not seem to be inferior to higher doses 10,12,14 . The "As low as reasonably achievable" (ALARA) fundamental principle of radioprotection is very well applicable to this clinical use of radiation.…”

Section: Discussionmentioning

confidence: 84%

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Percutaneous fractionated radiotherapy of the groin to eliminate lymphatic fistulas after vascular surgery

Jazmati

Tamaskovics

Hoff

et al. 2022

Preprint

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Background: Vascular surgery of the inguinal area can be complicated by persistent lymphatic fistulas. Rapid and effective treatment is essential to prevent infection, sepsis, bleeding, and possible leg amputation. Current data on irradiation of lymphatic fistulas lacks recommendation on the appropriate individual and total dose, the time of irradiation, and the target volume. Presumably, a dose of 0.3-0.5 to 1-12 Gy should be sufficient for the purpose. Currently, radiotherapy is a “can” recommendation, with a level 4 low evidence and a grade C recommendation, according to the DEGRO S2 guidelines. As part of a pilot study, we analyzed the impact and limitations of low-dose radiation therapy in the treatment of inguinal lymphatic fistulas.Patients and Methods: As part of an internal quality control project, patients with lymphatic fistulas irradiated in the groin area after vascular surgery for arterial occlusive disease (AOD) III-IV, repair of pseudo aneurysm or lymph node dissection due to melanoma were selected, and an exploratory analysis on retrospectively collected data performed.Results: Twelve patients (10 males and 2 females) aged 62.83 + 12.14 years underwent open vascular reconstruction for stage II (n= 2), III (n=1), and IV (n=7) arterial occlusive disease (AOD), lymph node dissection for melanoma (n=1) or repair of a pseudoaneurysm (n=1). Surgical vascular access was obtained through the groin and was associated with a persistent lymphatic fistula, secreting more than 50 ml/day. Patients were irradiated five times a week up to a maximum of 10 fractions for the duration of the radiation period. Fraction of 0.4 Gy were applied in the first 7 cases, while 5 patients were treated with a de-escalating dose of 0.3 Gy. There was a resolution of the lymphatic fistula in every patient without higher grade complications.Conclusion: Low-dose irradiation of the groin is a treatment option for persistent lymphatic fistula after inguinal vascular surgery.

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Section: Discussionmentioning

confidence: 84%

“…Different doses of radiation have been proposed to treat lymphatic stulas 7,8,12,13 . In the largest study to date, Hautmann et al, reported the use of 3 x 3 Gy at the start of the treatment 7 with an increase to 3 additional fractions of 3 Gy for persistent stulas.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous fractionated radiotherapy of the groin to eliminate lymphatic fistulas after vascular surgery

Jazmati

Tamaskovics

Hoff

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…Different doses of radiation have been proposed to treat lymphatic fistulas [ 7 , 8 , 12 , 13 ]. In the largest study to date, Hautmann et al reported the use of 3 × 3 Gy at the start of the treatment [ 7 ] with an increase to 3 additional fractions of 3 Gy for persistent fistulas.…”

Section: Discussionmentioning

confidence: 99%

“…Our data are consistent with what reported by Graz, Kazan and Zaporozhy. Low fraction doses of 0.3–0.5 Gy do not seem to be inferior to higher doses [ 10 , 12 , 14 ]. The “As low as reasonably achievable” (ALARA) fundamental principle of radioprotection is very well applicable to this clinical use of radiation.…”

Section: Discussionmentioning

confidence: 99%

“…The radiation treatment is usually stopped when the fistula output is less than 50 ml/ 24 h. In this cohort of 206 patients, R Ri is sk k f fa ac ct to or rs s f fo or r l ly ym mp ph ha at ti ic c f fi is st tu ul la as s Our data are consistent with what reported by Graz, Kazan and Zaporozhy. Low fraction doses of 0.3-0.5 Gy do not seem to be inferior to higher doses [10,12,14]. The "As low as reasonably achievable" (ALARA) fundamental principle of radioprotection is very well applicable to this clinical use of radiation.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Percutaneous fractionated radiotherapy of the groin to eliminate lymphatic fistulas after vascular surgery

et al. 2023

View full text Add to dashboard Cite

Background Vascular surgery of the inguinal area can be complicated by persistent lymphatic fistulas. Rapid and effective treatment is essential to prevent infection, sepsis, bleeding, and possible leg amputation. Current data on irradiation of lymphatic fistulas lack recommendation on the appropriate individual and total dose, the time of irradiation, and the target volume. Presumably, a dose of 0.3–0.5 to 1–12 Gy should be sufficient for the purpose. Currently, radiotherapy is a “can” recommendation, with a level 4 low evidence and a grade C recommendation, according to the DEGRO S2 guidelines. As part of a pilot study, we analyzed the impact and limitations of low-dose radiation therapy in the treatment of inguinal lymphatic fistulas. Patients and methods As a part of an internal quality control project, patients with lymphatic fistulas irradiated in the groin area after vascular surgery for arterial occlusive disease (AOD) III-IV, repair of pseudo aneurysm or lymph node dissection due to melanoma were selected, and an exploratory analysis on retrospectively collected data performed. Results Twelve patients (10 males and 2 females) aged 62.83 ± 12.14 years underwent open vascular reconstruction for stage II (n = 2), III (n = 1), and IV (n = 7) arterial occlusive disease (AOD), lymph node dissection for melanoma (n = 1) or repair of a pseudoaneurysm (n = 1). Surgical vascular access was obtained through the groin and was associated with a persistent lymphatic fistula, secreting more than 50 ml/day. Patients were irradiated five times a week up to a maximum of 10 fractions for the duration of the radiation period. Fraction of 0.4 Gy was applied in the first 7 cases, while 5 patients were treated with a de-escalating dose of 0.3 Gy. There was a resolution of the lymphatic fistula in every patient without higher grade complications. Conclusion Low-dose irradiation of the groin is a treatment option for persistent lymphatic fistula after inguinal vascular surgery.

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ExpEriEncE of combinEd (with roEntgEnothErapy) trEatmEnt of lymphorrhEa in thE groin aftEr artErial rEconstruction

Cited by 2 publications

References 0 publications

Percutaneous fractionated radiotherapy of the groin to eliminate lymphatic fistulas after vascular surgery

Percutaneous fractionated radiotherapy of the groin to eliminate lymphatic fistulas after vascular surgery

Percutaneous fractionated radiotherapy of the groin to eliminate lymphatic fistulas after vascular surgery

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