Intranodal lymphangiography under microsurgery for refractory lymphatic ascites after pelvic lymphadenectomy
Lymphatic ascites is a postoperative complication of lymph node dissection. Most symptomatic cases improve with conservative treatments. However, optimal management strategies for intractable lymphatic ascites remain controversial, and clinicians sometimes encounter intractable lymphatic ascites tha...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-04-01
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| Series: | Gynecologic Oncology Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352578924000250 |
| _version_ | 1827301694648614912 |
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| author | Shota Higami Yusuke Tanaka Daisuke Maeda Hiroshi Yukimoto Tomomi Ishii Yasuhiko Shiki |
| author_facet | Shota Higami Yusuke Tanaka Daisuke Maeda Hiroshi Yukimoto Tomomi Ishii Yasuhiko Shiki |
| author_sort | Shota Higami |
| collection | DOAJ |
| description | Lymphatic ascites is a postoperative complication of lymph node dissection. Most symptomatic cases improve with conservative treatments. However, optimal management strategies for intractable lymphatic ascites remain controversial, and clinicians sometimes encounter intractable lymphatic ascites that does not respond to conservative management.We herein report a case of postoperative intractable lymphatic ascites that was successfully treated with intranodal lymphangiography (LG) from inguinal lymph nodes under microsurgery. A 56-year-old woman was diagnosed with stage II endometrial cancer and underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic and para-aortic lymphadenectomies. On postoperative day (POD) 13, the patient presented with abdominal distention, and lymphatic ascites was diagnosed. Although the patient was treated with conservative management and lymphaticovenular anastomosis, her lymphatic ascites did not resolve. Finally, intranodal LG from the inguinal region was performed under microsurgery. A 2-cm incision was made on each side of the inguinal region. Once the lymph nodes were identified, a 23-gauge needle was inserted into the lymph node and lipiodol was injected. Extravasation of lipiodol into the abdomen from the left side of the lower pelvic region was confirmed. The postoperative course was uneventful. The ascites gradually decreased and disappeared within two weeks after LG. |
| first_indexed | 2024-03-07T23:06:14Z |
| format | Article |
| id | doaj.art-8cf8e9608dfe4fbe922068d89cc0cd6a |
| institution | Directory Open Access Journal |
| issn | 2352-5789 |
| language | English |
| last_indexed | 2024-04-24T16:30:39Z |
| publishDate | 2024-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Gynecologic Oncology Reports |
| spelling | doaj.art-8cf8e9608dfe4fbe922068d89cc0cd6a2024-03-30T04:39:23ZengElsevierGynecologic Oncology Reports2352-57892024-04-0152101346Intranodal lymphangiography under microsurgery for refractory lymphatic ascites after pelvic lymphadenectomyShota Higami0Yusuke Tanaka1Daisuke Maeda2Hiroshi Yukimoto3Tomomi Ishii4Yasuhiko Shiki5Department of Obstetrics and Gynecology, Osaka Rosai Hospital, Sakai, Osaka, Japan; Department of Obstetrics and Gynecology, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, JapanDepartment of Obstetrics and Gynecology, Osaka Rosai Hospital, Sakai, Osaka, Japan; Corresponding author at: Department of Obstetrics and Gynecology, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Kita-ku, Sakai, Osaka 591-8025, Japan.Department of Plastic Surgery, Osaka Rosai Hospital, Sakai, Osaka, JapanDepartment of Diagnostic Radiology, Osaka Rosai Hospital, Sakai, Osaka, JapanDepartment of Obstetrics and Gynecology, Osaka Rosai Hospital, Sakai, Osaka, JapanDepartment of Obstetrics and Gynecology, Osaka Rosai Hospital, Sakai, Osaka, JapanLymphatic ascites is a postoperative complication of lymph node dissection. Most symptomatic cases improve with conservative treatments. However, optimal management strategies for intractable lymphatic ascites remain controversial, and clinicians sometimes encounter intractable lymphatic ascites that does not respond to conservative management.We herein report a case of postoperative intractable lymphatic ascites that was successfully treated with intranodal lymphangiography (LG) from inguinal lymph nodes under microsurgery. A 56-year-old woman was diagnosed with stage II endometrial cancer and underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic and para-aortic lymphadenectomies. On postoperative day (POD) 13, the patient presented with abdominal distention, and lymphatic ascites was diagnosed. Although the patient was treated with conservative management and lymphaticovenular anastomosis, her lymphatic ascites did not resolve. Finally, intranodal LG from the inguinal region was performed under microsurgery. A 2-cm incision was made on each side of the inguinal region. Once the lymph nodes were identified, a 23-gauge needle was inserted into the lymph node and lipiodol was injected. Extravasation of lipiodol into the abdomen from the left side of the lower pelvic region was confirmed. The postoperative course was uneventful. The ascites gradually decreased and disappeared within two weeks after LG.http://www.sciencedirect.com/science/article/pii/S2352578924000250LymphangiographyLymphatic ascitesLymphocystLymphaticovenular anastomosisMicrosurgeryLymphadenectomy |
| spellingShingle | Shota Higami Yusuke Tanaka Daisuke Maeda Hiroshi Yukimoto Tomomi Ishii Yasuhiko Shiki Intranodal lymphangiography under microsurgery for refractory lymphatic ascites after pelvic lymphadenectomy Gynecologic Oncology Reports Lymphangiography Lymphatic ascites Lymphocyst Lymphaticovenular anastomosis Microsurgery Lymphadenectomy |
| title | Intranodal lymphangiography under microsurgery for refractory lymphatic ascites after pelvic lymphadenectomy |
| title_full | Intranodal lymphangiography under microsurgery for refractory lymphatic ascites after pelvic lymphadenectomy |
| title_fullStr | Intranodal lymphangiography under microsurgery for refractory lymphatic ascites after pelvic lymphadenectomy |
| title_full_unstemmed | Intranodal lymphangiography under microsurgery for refractory lymphatic ascites after pelvic lymphadenectomy |
| title_short | Intranodal lymphangiography under microsurgery for refractory lymphatic ascites after pelvic lymphadenectomy |
| title_sort | intranodal lymphangiography under microsurgery for refractory lymphatic ascites after pelvic lymphadenectomy |
| topic | Lymphangiography Lymphatic ascites Lymphocyst Lymphaticovenular anastomosis Microsurgery Lymphadenectomy |
| url | http://www.sciencedirect.com/science/article/pii/S2352578924000250 |
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