Management of postoperative lymphoceles after lymphadenectomy: Percutaneous catheter drainage with and without povidone-iodine sclerotherapy Journal Article

  


Authors: Alago, W. Jr; Deodhar, A.; Michell, H.; Sofocleous, C. T.; Covey, A. M.; Solomon, S. B.; Getrajdman, G. I.; Dalbagni, G.; Brown, K. T.
Article Title: Management of postoperative lymphoceles after lymphadenectomy: Percutaneous catheter drainage with and without povidone-iodine sclerotherapy
Abstract: Purpose: To report our single-center experience in managing symptomatic lymphoceles after lymphadenectomy for genitourinary and gynecologic malignancy and to compare clinical outcomes of percutaneous catheter drainage (PCD) alone versus PCD with transcatheter povidone-iodine sclerotherapy (TPIS). Methods: The medical records of patients who presented for percutaneous drainage of pelvic lymphoceles from February 1999 to September 2007 were retrospectively reviewed. Catheters with prolonged outputs >50 cc/day were treated with TPIS. Technical success was defined as the ability to achieve complete resolution of the lymphocele. Clinical success was defined as resolution of the patient's symptoms that prompted the intervention. Results: Sixty-four patients with 70 pelvic lymphoceles were treated. Forty-six patients (71.9 %) had PCD, and 18 patients (28.1 %) had multisession TPIS. The mean initial cavity size was 294.9 cc for those treated with TPIS and 228.2 cc for those treated with PCD alone (range 15-1,600) (p = 0.59). Mean duration of catheter drainage was 19 days (29 days with TPIS, 16 days with PCD, p = 0.001). Mean clinical follow-up was 22.6 months. Technical success was 74.3 % with PCD and 100 % with TPIS. Clinical success was 97 % with PCD and 100 % with TPIS. Postprocedural complications included pericatheter fluid leakage (n = 4), catheter dislodgement (n = 3), catheter occlusion (n = 9), and secondary infection of the collection (n = 4). Conclusion: PCD of symptomatic lymphoceles is an effective postoperative management technique. Initial cavity size is not an accurate predictor of the need for TPIS. When indicated, TPIS is safe and effective with catheter outputs >50 cc/day. © 2012 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).
Keywords: adult; treatment outcome; middle aged; major clinical study; cancer staging; outcome assessment; follow up; lymph node dissection; pelvis; lymph node excision; computer assisted tomography; infection; tomography, x-ray computed; retrospective study; urogenital tract cancer; postoperative complications; urogenital neoplasms; echography; experience; medical record; catheterization; radiography, interventional; contrast media; povidone iodine; gynecologic cancer; percutaneous drainage; drainage; ultrasonography, interventional; iatrogenic disease; fluoroscopy; catheter occlusion; lymphocele; catheter dislodgement; sclerotherapy; povidone-iodine; sclerosing solutions; povidone-iodine (pi); percutaneous catheter drainage; pericatheter fluid leakage; transcatheter povidone iodine sclerotherapy
Journal Title: CardioVascular and Interventional Radiology
Volume: 36
Issue: 2
ISSN: 0174-1551
Publisher: Springer  
Date Published: 2013-04-01
Start Page: 466
End Page: 471
Language: English
DOI: 10.1007/s00270-012-0375-3
PROVIDER: scopus
PUBMED: 22484702
DOI/URL:

http://www.scopus.com/inward/record.url?eid=2-s2.0-84875212076&partnerID=40&md5=a6eacefc3403e1222ebb1b62ae343bc4
Notes: --- - "Export Date: 1 April 2013" - "CODEN: CARAD" - "Source: Scopus"
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MSK Authors
  1. William Alago
    25 Alago
  2. Guido Dalbagni
    325 Dalbagni
  3. George I Getrajdman
    118 Getrajdman
  4. Anne Covey
    166 Covey
  5. Ajita Deodhar
    11 Deodhar
  6. Karen T Brown
    178 Brown
  7. Stephen Solomon
    423 Solomon
  8. Constantinos T Sofocleous
    245 Sofocleous
  9. Hans Michell
    1 Michell
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