Intranodal Lymphangiography and Embolization for the Treatment of Early Postoperative Lymphatic Leaks after Pelvic Surgery
- Authors
- Lee, Kyungmin; Chang, Suk-Joon; Won, Je Hwan; Kwon, Yohan; Kim, Seong Ho; Kim, Jeong Eun; Kim, Jinoo
- Issue Date
- Apr-2023
- Publisher
- ELSEVIER SCIENCE INC
- Citation
- JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, v.34, no.4, pp.591 - 599.e1
- Indexed
- SCIE
SCOPUS
- Journal Title
- JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY
- Volume
- 34
- Number
- 4
- Start Page
- 591
- End Page
- 599.e1
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/186066
- DOI
- 10.1016/j.jvir.2022.12.020
- ISSN
- 1051-0443
- Abstract
- Purpose: To assess outcome and predictors of outcome after lymphatic embolization (LE) for early postoperative lymphatic leak after pelvic surgery.
Material and Methods: Lymphangiography (LG) procedures performed between May 2015 and February 2020 for postoperative intraperitoneal lymphatic leaks after pelvic surgery were reviewed. Treatment indication was lymphatic drainage of >500 mL/d persisting for >1 week. LE was performed by injecting glue into the iliac lymph node. Fisher exact and Wilcoxon rank-sum tests were used for comparative analysis, and logistic regression was used to assess predictors of outcome.
Results: LG was performed in 71 patients. A leak was demonstrated in 69 patients who underwent LE. The mean drainage was 1,329 mL/d ± 773. Catheters were removed in 49 (69.0%) patients after 1 procedure and in 69 (97.2%) patients after a mean of 1.3 procedures. The mean drainage at the time of catheter removal was 157 mL/d ± 100. Failure occurred in 12 (16.9%) cases, including 2 (2.8%) cases of unsuccessful catheter removal and 10 (14.1%) cases of catheter reinsertion owing to recurrent ascites (n = 3) and lymphoceles (n = 7). Older age and drainage of >1,500 mL/d were associated with failure (P = .004). Drainage of >1,500 mL/d was associated with a post-LE catheter dwell time of longer than 1 week (P = .024). Minor adverse events were noted in 4 (5.6%) patients who presented with transient leg swelling.
Conclusions: LE was effective for treating pelvic surgery-related lymphatic leaks. Reintervention may be required. Drainage of >1,500 mL/d was associated with clinical failure and a post-LE catheter dwell time of longer than 1 week.
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