Long-Term Clinical Outcome of Abdomino-Thoracic Lymphatic Interventions of Traumatic and Non-Traumatic Lymphatic Leakage in Adults
The aim of this study was to retrospectively evaluate the long-term results of lymphatic interventions in adults with abdomino-thoracic lymphatic pathologies. Management of abdomino-thoracic chylous effusions in adults undergoing X-ray-lymphangiography with or without lymph-vessel embolization (LVE)...
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MDPI AG
2023-09-01
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| Online Access: | https://www.mdpi.com/2227-9059/11/9/2556 |
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| author | Lea C. Kaminski Julia Wagenpfeil Jens Buermann Philipp L. Lutz Julian A. Luetkens Ulrike I. Attenberger Christian P. Strassburg Jörg C. Kalff Hans H. Schild Claus C. Pieper |
| author_facet | Lea C. Kaminski Julia Wagenpfeil Jens Buermann Philipp L. Lutz Julian A. Luetkens Ulrike I. Attenberger Christian P. Strassburg Jörg C. Kalff Hans H. Schild Claus C. Pieper |
| author_sort | Lea C. Kaminski |
| collection | DOAJ |
| description | The aim of this study was to retrospectively evaluate the long-term results of lymphatic interventions in adults with abdomino-thoracic lymphatic pathologies. Management of abdomino-thoracic chylous effusions in adults undergoing X-ray-lymphangiography with or without lymph-vessel embolization (LVE) from 2010–2018 was reviewed. Patients underwent lymphangiography alone when imaging showed normal findings or lymphatic obstruction without leakage or reflux; otherwise, LVE was performed (leakage, reflux, obstruction with leakage or reflux, lymphatic masses). Technical and clinical success, complications, and long-term outcomes were assessed. 78 patients (47 male, median age 56.3 years) were treated for chylous effusions (60.3% traumatic, 39.7% non-traumatic). Lymphangiography showed leakage (48.7%), reflux (14.1%), obstruction (28.2%), lymphatic masses (5.1%), and normal findings (3.8%). Embolization was performed in 49/78 (62.8%) cases. Overall, treatment was clinically successful in 74.4% (mean follow-up of 28 months), with significant differences between LVE and lymphangiography (91.8% vs. 44.8%; <i>p</i> < 0.001), traumatic and non-traumatic etiologies (89.4% vs. 51.6%; <i>p</i> < 0.001), and leakage locations (<i>p</i> = 0.003). The clinical success of LVE did not differ between leakage etiologies or locations. Complications occurred in 5 patients (2/5 needed treatment). Patients survived significantly longer after successful treatment (2679 vs. 927 days; <i>p</i> = 0.044) and without malignancy (3214 vs. 1550 days; <i>p</i> = 0.043). Lymphatic interventions are safe and effective. LVE should be attempted whenever feasible, as success is high (>90%). Successful intervention has a positive effect on patient survival. |
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| institution | Directory Open Access Journal |
| issn | 2227-9059 |
| language | English |
| last_indexed | 2024-03-10T23:00:35Z |
| publishDate | 2023-09-01 |
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| spelling | doaj.art-ab3161bd047342d3991fa8807b259e0e2023-11-19T09:42:58ZengMDPI AGBiomedicines2227-90592023-09-01119255610.3390/biomedicines11092556Long-Term Clinical Outcome of Abdomino-Thoracic Lymphatic Interventions of Traumatic and Non-Traumatic Lymphatic Leakage in AdultsLea C. Kaminski0Julia Wagenpfeil1Jens Buermann2Philipp L. Lutz3Julian A. Luetkens4Ulrike I. Attenberger5Christian P. Strassburg6Jörg C. Kalff7Hans H. Schild8Claus C. Pieper9Department of Diagnostic and Interventional Radiology, University Hospital of Bonn, 53127 Bonn, GermanyDepartment of Diagnostic and Interventional Radiology, University Hospital of Bonn, 53127 Bonn, GermanyDepartment of General, Visceral, Thoracic and Vascular Surgery, University Hospital of Bonn, 53127 Bonn, GermanyDepartment of Internal Medicine I, University Hospital of Bonn, 53127 Bonn, GermanyDepartment of Diagnostic and Interventional Radiology, University Hospital of Bonn, 53127 Bonn, GermanyDepartment of Diagnostic and Interventional Radiology, University Hospital of Bonn, 53127 Bonn, GermanyDepartment of Internal Medicine I, University Hospital of Bonn, 53127 Bonn, GermanyDepartment of General, Visceral, Thoracic and Vascular Surgery, University Hospital of Bonn, 53127 Bonn, GermanyDepartment of Diagnostic and Interventional Radiology, University Hospital of Bonn, 53127 Bonn, GermanyDepartment of Diagnostic and Interventional Radiology, University Hospital of Bonn, 53127 Bonn, GermanyThe aim of this study was to retrospectively evaluate the long-term results of lymphatic interventions in adults with abdomino-thoracic lymphatic pathologies. Management of abdomino-thoracic chylous effusions in adults undergoing X-ray-lymphangiography with or without lymph-vessel embolization (LVE) from 2010–2018 was reviewed. Patients underwent lymphangiography alone when imaging showed normal findings or lymphatic obstruction without leakage or reflux; otherwise, LVE was performed (leakage, reflux, obstruction with leakage or reflux, lymphatic masses). Technical and clinical success, complications, and long-term outcomes were assessed. 78 patients (47 male, median age 56.3 years) were treated for chylous effusions (60.3% traumatic, 39.7% non-traumatic). Lymphangiography showed leakage (48.7%), reflux (14.1%), obstruction (28.2%), lymphatic masses (5.1%), and normal findings (3.8%). Embolization was performed in 49/78 (62.8%) cases. Overall, treatment was clinically successful in 74.4% (mean follow-up of 28 months), with significant differences between LVE and lymphangiography (91.8% vs. 44.8%; <i>p</i> < 0.001), traumatic and non-traumatic etiologies (89.4% vs. 51.6%; <i>p</i> < 0.001), and leakage locations (<i>p</i> = 0.003). The clinical success of LVE did not differ between leakage etiologies or locations. Complications occurred in 5 patients (2/5 needed treatment). Patients survived significantly longer after successful treatment (2679 vs. 927 days; <i>p</i> = 0.044) and without malignancy (3214 vs. 1550 days; <i>p</i> = 0.043). Lymphatic interventions are safe and effective. LVE should be attempted whenever feasible, as success is high (>90%). Successful intervention has a positive effect on patient survival.https://www.mdpi.com/2227-9059/11/9/2556chylothoraxchylous asciteslymphangiography |
| spellingShingle | Lea C. Kaminski Julia Wagenpfeil Jens Buermann Philipp L. Lutz Julian A. Luetkens Ulrike I. Attenberger Christian P. Strassburg Jörg C. Kalff Hans H. Schild Claus C. Pieper Long-Term Clinical Outcome of Abdomino-Thoracic Lymphatic Interventions of Traumatic and Non-Traumatic Lymphatic Leakage in Adults Biomedicines chylothorax chylous ascites lymphangiography |
| title | Long-Term Clinical Outcome of Abdomino-Thoracic Lymphatic Interventions of Traumatic and Non-Traumatic Lymphatic Leakage in Adults |
| title_full | Long-Term Clinical Outcome of Abdomino-Thoracic Lymphatic Interventions of Traumatic and Non-Traumatic Lymphatic Leakage in Adults |
| title_fullStr | Long-Term Clinical Outcome of Abdomino-Thoracic Lymphatic Interventions of Traumatic and Non-Traumatic Lymphatic Leakage in Adults |
| title_full_unstemmed | Long-Term Clinical Outcome of Abdomino-Thoracic Lymphatic Interventions of Traumatic and Non-Traumatic Lymphatic Leakage in Adults |
| title_short | Long-Term Clinical Outcome of Abdomino-Thoracic Lymphatic Interventions of Traumatic and Non-Traumatic Lymphatic Leakage in Adults |
| title_sort | long term clinical outcome of abdomino thoracic lymphatic interventions of traumatic and non traumatic lymphatic leakage in adults |
| topic | chylothorax chylous ascites lymphangiography |
| url | https://www.mdpi.com/2227-9059/11/9/2556 |
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