Intranodal lymphangiography and embolization for management of iatrogenic chylous ascites after oncological surgery Journal Article
| Authors: | Aly, A. K.; Santos, E.; Fung, J.; Maybody, M.; Youssef, E. W.; Petre, E. N.; Gonzalez-Aguirre, A. J.; Moussa, A. M. |
| Article Title: | Intranodal lymphangiography and embolization for management of iatrogenic chylous ascites after oncological surgery |
| Abstract: | Purpose: To investigate the safety and effectiveness of intranodal lymphangiography (INL) and lymphatic embolization (LE) in management of chylous ascites after oncologic surgery. Materials and Methods: Retrospective review of records of patients who underwent INL with or without LE from January 2017 to June 2022 was performed. Adult patients with chylous ascites after oncologic surgery referred to interventional radiology after failure of conservative treatment were included. Thirty-nine patients who underwent 55 procedures were included (34 males and 5 females). Data on patient demographics, procedural technique, outcomes, and follow-up were collected. Descriptive statistics were used to illustrate technical success, clinical success, and adverse events. Univariate logistic regression analysis was performed to evaluate factors predicting clinical success. Results: INL was technically successful in 54 of 55 procedures (98%; 95% confidence interval [CI], 90%–100%). A lymphatic leak was identified in 40 procedures, and LE was attempted in 36. LE was technically successful in 33 of the 36 procedures (92%; 95% CI, 78%–98%). Clinical success, defined as resolution of ascites with no need for peritoneovenous shunt placement or additional surgery, was achieved in 22 of 39 patients (56%; 95% CI, 40%–72%). Clinical success was achieved in 18 patients after 1 procedure, and patients who required repeat procedures were less likely to achieve clinical success (odds ratio, 0.16; 95% CI, 0.04–0.66; P = .012). Four grade 1 procedural adverse events were recorded. Conclusions: INL with or without LE is a safe minimally invasive tool that can help patients with chylous ascites after oncologic surgery who failed conservative treatment avoid more invasive interventions. © 2024 SIR |
| Keywords: | adult; clinical article; controlled study; treatment outcome; aged; aged, 80 and over; middle aged; retrospective studies; iodinated poppyseed oil; follow up; lymph node dissection; neoplasm; neoplasms; cohort analysis; risk factors; diagnostic imaging; retrospective study; risk factor; time factors; conservative treatment; predictive value of tests; interventional radiology; radiography, interventional; surgery; therapy; embolization, therapeutic; predictive value; chylous ascites; iatrogenic disease; repeat procedure; etiology; lymphangiography; adverse event; complication; time factor; lymphography; extravasation; very elderly; humans; human; male; female; article; artificial embolization |
| Journal Title: | Journal of Vascular and Interventional Radiology |
| Volume: | 35 |
| Issue: | 6 |
| ISSN: | 1051-0443 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2024-06-01 |
| Start Page: | 883 |
| End Page: | 889 |
| Language: | English |
| DOI: | 10.1016/j.jvir.2024.02.015 |
| PUBMED: | 38789205 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF -- Source: Scopus |
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