Lymphocele: prevalence and management in gynecological malignancies

Abstract

A lymphocele is a cystic mass that may occur in the retroperitoneum following a systematic pelvic and/or para-aortic lymphadenectomy. Lymphoceles may be the cause of severe morbidity, or rarely mortality. Symptomatic lymphoceles manifest with pain, compression of adjacent structures, lymphoedema, deep vein thrombosis or inflammation. The morbidity associated with a symptomatic lymphocele may reduce the quality of life of a patient, as well as delay subsequent cancer treatment. The number and positivity of removed lymph nodes, surgical approach, type of tumor, radiotherapy and BMI rate are among the most discussed risk factors of lymphocele formation. The incidence of postoperative lymphocele is reported in the broad range of 1-58%; 5-18% of those who are symptomatic. Only symptomatic lymphoceles should be treated. Mini-invasive methods involving catheter drainage and sclerotization tend to prevail. Surgery either via laparoscopy or laparotomy remains an option in recurring, poorly accessible or inflammatory lymphoceles.

Incidence of and risk factors for lymphocele formation after lateral pelvic lymph node dissection for rectal cancer: a retrospective study

“…Pelvic lymphocele is typically found incidentally during routine CT follow-up after surgery; however, it is sometimes symptomatic, requiring treatment [9][10][11]21]. In gynaecology and urology, several studies have shown that pelvic lymphocele is one of the most common complications after pelvic lymphadenectomy [12,13,22,23]. There have been many studies reporting complications associated with LPND following rectal cancer surgery [24][25][26][27][28][29][30].…”

“…Lateral pelvic lymph node (LPN) metastasis has been reported to occur in 17. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22].4% of patients with locally advanced lower rectal cancer [1,2]. The treatment strategy for lower rectal cancer differs between Western countries and Japan.…”

“…In many cases, lymphoceles are asymptomatic and disappear spontaneously, but they are sometimes symptomatic, requiring treatment intervention [9][10][11]. Rates of incidence of lymphoceles have been reported as 10.5-47.3% and 12.6-51%, respectively, after gynaecological [12][13][14] and urological procedures [15][16][17][18]. However, no evidence of pelvic lymphocele formation following rectal cancer surgery has been reported thus far.…”

Effect of using magnifying loupe glasses on lymphocele formation and surgical outcomes in gynecologic oncology

“…However, they may rarely affect the ureter and bladder (hydronephrosis, urinary frequency), bowel (ileus, tenesmus), or vessels (thrombosis) and cause abdominal pain. Lymphoceles may also become infected (1,2) . The incidence of lymphoceles after gynecologic cancer surgery is reported as 1-58%.…”

Lymphatic cysts after gynecological cancer surgery: risk factors, diagnosis and treatment

“…Тем не менее пациенты, перенесшие лимфодиссекцию, часто страдают от различных послеоперационных осложнений, в частности обусловленных нарушением целостности лимфатического аппарата. Стенка лимфатического сосуда содержит малую долю гладкой мускулатуры и не способна к вазоконстрикции, вследствие этого лимфатические сосуды остаются в открытом состоянии в течение 48 ч после травмы [3]. Массивное повреждение лимфатических сосудов в результате лимфодиссекции приводит к развитию послеоперационных лимфатических осложнений -лимфатических кист, лимфедемы, лимфореи [4].…”