Postoperative pelvic lymphocele: treatment with simple percutaneous catheter drainage.
OBJECTIVE
To evaluate the effectiveness of simple percutaneous catheter drainage in the treatment of postoperative lymphocele.


METHODS
Percutaneous catheter drainage of 23 symptomatic lymphoceles was performed with ultrasonographic (US) guidance in 20 patients who had undergone radical pelvic lymphadenectomy because of uterine malignancy. All lymphoceles were diagnosed on the basis of biochemical and cytologic findings in aspirated fluid. The drainage catheter was removed when the amount of daily drainage was less than 10 mL per day and when the lymphocele was seen at imaging to have resolved. Follow-up US was performed at 1, 3, and 6 months after catheter removal. The results were classified as success, partial success, or failure.


RESULTS
Lymphoceles ranged in size from 5 x 4 x 3 to 25 x 10 x 10 cm. Mean total drainage volume was 2,012 mL (range, 300-17,240 mL). Fluid from 10 lymphoceles (43%) was positive at Gram staining and bacteriologic culture; fluid from 13 (57%) was sterile. Duration of catheter drainage was 3-49 days (mean, 22 days). Twenty (87%) lymphoceles resolved completely; three (13%) recurred. Two recurrent lymphoceles were again treated with percutaneous catheter drainage; the third resolved spontaneously 5 months after catheter removal. Successful treatment was ultimately achieved in all patients. Postprocedural complications occurred in four patients. One had a secondary infection of lymphocele; one, catheter dislodgment; and two, skin infection at the site of catheter insertion.


CONCLUSIONS
Percutaneous catheter drainage is safe and effective for treatment of symptomatic postoperative lymphoceles.
Kim
J K
JK
Department of Diagnostic Radiology, Chonnam University Medical School, Dongku, Kwangju, South Korea. kjkrad@chonnam.chonnam.ac.kr
Jeong
Y Y
YY
Kim
Y H
YH
Kim
Y C
YC
Kang
H K
HK
Choi
H S
HS
D002404:Catheterization; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008210:Lymphocele / Q000000981:diagnostic imaging / Q000628:therapy*; D008875:Middle Aged; D010388:Pelvis; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000628:therapy*; D011859:Radiography; D014463:Ultrasonography; D014594:Uterine Neoplasms / Q000601:surgery