Sclerotherapy in the management of postoperative lymphocele.

Abstract

PURPOSE:

To describe a single-center experience with sclerotherapy of postoperative lymphocele and to determine the risk factors for failure of treatment.

MATERIALS AND METHODS:

From 1999 to 2007, 43 patients with postsurgical lymphocele were treated with sclerotherapy with a combination of povidone iodine, alcohol, and doxycycline. The treatments were repeated at weekly intervals. The initial drainage volume of the lymphocele, the location of the lymphocele, the number of treatments, and the outcomes were retrospectively collected.

RESULTS:

In 38 patients, the lymphocele was drained percutaneously, and in five patients, the treatment was initiated through an existing surgically placed drainage tube. Sclerotherapy was successful in 33 patients (77%). Complications that resulted in termination of the treatment were seen in five patients (12%): testicular pain, cellulitis, posttreatment increase in creatinine, acute renal tubular necrosis, and abdominal infection. In one of these patients the lymphocele resolved after resolution of the infection. The average number of treatments was four (range, 1-14). There was no difference in success rate between superficial intraabdominal and soft-tissue lymphoceles. There was a significant difference (P < .05) in the fluid volume at initial drainage between the failure group (1,708 mL +/- 1,521) and the success group (206 mL +/- 213). This assumes an attempt was made to drain the collection completely at the initial procedure.

CONCLUSIONS:

Sclerotherapy of postoperative lymphoceles is an effective treatment. Success of sclerotherapy is directly related to the size of the lymphocele cavity.

• Authors: Arie Mahrer, Parvati Ramchandani, Scott O Trerotola, Richard D Shlansky-Goldberg, Maxim Itkin
• Journal: Journal of vascular and interventional radiology : JVIR (J Vasc Interv Radiol) Vol. 21 Issue 7 Pg. 1050-3 (Jul 2010) ISSN: 1535-7732 [Electronic] United States
• PMID: 20537556 (Publication Type: Clinical Trial, Journal Article)
• Copyright: Copyright 2010 SIR. Published by Elsevier Inc. All rights reserved.

Chemical References

• Sclerosing Solutions

Topics

• Adult
• Aged
• Female
• Humans
• Lymphocele (diagnosis, drug therapy)
• Male
• Middle Aged
• Postoperative Complications (therapy)
• Sclerosing Solutions (administration & dosage)
• Sclerotherapy (methods)
• Treatment Outcome