Interventional solutions for post-surgical problems: A lymphatic leaks review Review
| Authors: | Gómez, F. M.; Baetens, T. R.; Santos, E.; Rocha, B. L.; Horwitz, B.; Lojo-Lendoiro, S.; Vargas, P.; Patel, P.; Beets-Tan, R.; Martínez-Rodrigo, J. J.; Bonmatí, L. M. |
| Review Title: | Interventional solutions for post-surgical problems: A lymphatic leaks review |
| Abstract: | The lymphatic circulation plays a crucial role in maintaining fluid balance and supporting immune responses by returning serum proteins and lipids to the systemic circulation. Lymphatic leaks, though rare, pose significant challenges post-radical neck surgery, oesophagectomy, and thoracic or retroperitoneal oncological resections, leading to heightened morbidity and mortality. Managing lymphatic leaks necessitates consideration of aetiology, severity, and volume of leakage. Traditionally, treatment involved conservative measures such as dietary restrictions, drainage, and medical management, with surgical intervention reserved for severe cases, albeit with variable outcomes and extended recovery periods. Lymphography, introduced in the 1950s, initially served as a diagnostic tool for lymphoedema, lymphoma, tumour staging, and monitoring chemotherapy response. However, its widespread adoption was impeded by alternative techniques like Computed Tomography, learning curves, and its associated complications. Contemporary lymphatic interventions have evolved, favouring nodal lymphangiography over pedal lymphangiography for its technical simplicity and reduced complexity. Effective management of chylous leaks mandates a multimodal approach encompassing clinical evaluation and imaging techniques. In cases where conservative management proves ineffective, embolization through conventional lymphangiography by bipedal dissection or intranodal injection emerges as a viable option. This review underscores the importance of a comprehensive approach to diagnosing and treating lymphatic leaks, highlighting advancements in imaging and therapeutic interventions that enhance patient outcomes. © The Author(s) 2024. |
| Keywords: | treatment outcome; aged; middle aged; major clinical study; review; cancer staging; computer assisted tomography; lymph vessel; lymphedema; immune response; conservative treatment; diagnosis; lymphoma; clinical evaluation; surgery; chyle; diet restriction; esophagectomy; systemic circulation; plasma protein; prevention; lymphangiography; embolization; lymph flow; complication; learning curve; lymphography; human; male; female; fluid balance; artificial embolization; lymhangiography; surgical lymphatic leak |
| Journal Title: | CVIR Endovascular |
| Volume: | 7 |
| ISSN: | 2520-8934 |
| Publisher: | Springer Nature |
| Date Published: | 2024-08-10 |
| Start Page: | 61 |
| Language: | English |
| DOI: | 10.1186/s42155-024-00473-3 |
| PROVIDER: | scopus |
| PMCID: | PMC11316727 |
| PUBMED: | 39126551 |
| DOI/URL: | |
| Notes: | PDF affiliates are incorrect, Dr. Ernesto Santos is the only MSK affiliated author -- Erratum issued, see DOI: 10.1186/s42155-024-00483-1 -- Source: Scopus |
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