Lymphocele Developed After Pelvic Lymphadenectomy: Treatment by Percutaneous Catheter Drainage

ABSTRACT

PURPOSE: To evaluate the efficacy of percutaneous catheter drainage for the treatment of postoperative lymphoceles following pelvic lymphadenectomy. MATERIALS AND METHODS: Between January 1995 and May 1996, 23 symptomatic lymphoceles in 20 patients who had undergone pelvic lymphadenectomy for uterine cancer were subjected to percutaneous catheter drainage under sonographic guidance. All the lymphoceles were confirmed by biochemical and cytological examination. When the amount of drainage decreased to less than 5-10ml/day and when the lymphocele was seen on US or sinography to have collapsed, the catheter was removed. US and sinography were performed to evaluate the efficacy of treatment at 1 week after catheter drainage, and all patients were followed up with US at 1, 3, and 6 months after catheter removal. RESULTS: On follow-up sonography, 20 of 23 lymphoceles (87.0%) were seen to have collapsed completely and three had recurred. Of these latter, two were treated by secondary percutaneous catheter drainage, and the other, which was asymptomatic and small, had collapsed spontaneously during the fifth months after catheter removal. Successful treatment of lymphocele was eventually achieved in all patients. The duration of catheter drainage ranged from 3 to 49 (mean, 22) days, and the size of lymphocele on initial sinogram varied from 5x4x3cm to 25x10x10cm; the total volume of drainage ranged from 300 to 17,240 (mean2,012)ml. Complications during the procedure and drainage arose in three cases. In one, there was secondary infection of the lymphocele, and in two, infection at the site of catheter insertion was seen; treatment involved changing the catheter and antibiotics. CONCLUSION: Percutaneous catheter drainage is thought to be a safe and effective alternative to surgery for the treatment of symptomatic lymphoceles following pelvic lymphadenectomy for uterine cancer.