Intraoperative mapping with isosulfan blue of lymphatic leakage during inguinal lymph node dissection (ILND) for skin cancer for the prevention of postoperative lymphocele

Abstract

The technique during inguinal lymph node dissection presented herein is useful for the prevention of postoperative lymphocele.

A review of the postoperative lymphatic leakage

“…0.6% to 22% of kidney transplantations at the lower or upper medial region develop postoperative lymphoceles [ 38 , 42 ]. Inguinal lymphocele is also a well-known complication of inguinal lymph nodes dissection (ILND) for penile and vulvar cancer, with an incidence ranging from 5% to 87% [ 43 , 44 ].…”

“…The volume of drainage is also an important index to evaluate the condition and to make the next therapeutic protocol of the patient. Percutaneous drainage is a safe method to deal with lymphatic leakage, especially lymphocele but with a high recurrence rate (up to 50%) [ 17 , 43 ]. Combining with percutaneous drainage with a sclerosing agent, including doxycycline, tetracycline, bleomycin, OK-432, povidone-iodine, lipiodol and ethanol, can significantly decrease the recurrence rate [ 78 , 96 , 107 ].…”

Treatment of lymphocele with negative pressure wound therapy post inguinal mass excision: A case-report

“…Inguinal lymphocele is a well-known complication after inguinal lymphadenectomy [14,15]. Therefore, as a preventive measure, the coagulation of lymphatic channels is necessary, even if a leakage site is not identified.…”

Sentinel Lymph Node Biopsy for Melanoma and Surgical Approach to Lymph Node Metastasis

“…As another procedure in an attempt to decrease lymphocele, Nakamura et al reported a simple method using intraoperative injection of isosulfan blue during inguinal LND without modifications to identify leakage from an injured lymphatic vessels for the prevention of lymphocele (Fig. 7) [112]. There was no incidence of lymphocele in the isosulfan blue injection group and the lymphatic drainage output from the inguinal region was clearly less, leading to early removal of the suction catheter.…”