title: Management of postoperative lymphoceles after lymphadenectomy: percutaneous catheter drainage with and without povidone-iodine sclerotherapy.
abstract: OBJECTIVE
  To report our single-center experience in managing symptomatic lymphoceles after lymphadenectomy for genitourinary and gynecologic malignancy and to compare clinical outcomes of percutaneous catheter drainage (PCD) alone versus PCD with transcatheter povidone-iodine sclerotherapy (TPIS).
  
  
  METHODS
  The medical records of patients who presented for percutaneous drainage of pelvic lymphoceles from February 1999 to September 2007 were retrospectively reviewed. Catheters with prolonged outputs >50 cc/day were treated with TPIS. Technical success was defined as the ability to achieve complete resolution of the lymphocele. Clinical success was defined as resolution of the patient's symptoms that prompted the intervention.
  
  
  RESULTS
  Sixty-four patients with 70 pelvic lymphoceles were treated. Forty-six patients (71.9 %) had PCD, and 18 patients (28.1 %) had multisession TPIS. The mean initial cavity size was 294.9 cc for those treated with TPIS and 228.2 cc for those treated with PCD alone (range 15-1,600) (p = 0.59). Mean duration of catheter drainage was 19 days (29 days with TPIS, 16 days with PCD, p = 0.001). Mean clinical follow-up was 22.6 months. Technical success was 74.3 % with PCD and 100 % with TPIS. Clinical success was 97 % with PCD and 100 % with TPIS. Postprocedural complications included pericatheter fluid leakage (n = 4), catheter dislodgement (n = 3), catheter occlusion (n = 9), and secondary infection of the collection (n = 4).
  
  
  CONCLUSIONS
  PCD of symptomatic lymphoceles is an effective postoperative management technique. Initial cavity size is not an accurate predictor of the need for TPIS. When indicated, TPIS is safe and effective with catheter outputs >50 cc/day.
authors.affiliation: Interventional Radiology Service, Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA. alagow@mskcc.org
authors.forename: William
authors.initials: W
authors.lastname: Alago
authors.forename: Ajita
authors.initials: A
authors.lastname: Deodhar
authors.forename: Hans
authors.initials: H
authors.lastname: Michell
authors.forename: Constantinos T
authors.initials: CT
authors.lastname: Sofocleous
authors.forename: Anne M
authors.initials: AM
authors.lastname: Covey
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Solomon
authors.forename: George I
authors.initials: GI
authors.lastname: Getrajdman
authors.forename: Guido
authors.initials: G
authors.lastname: Dalbagni
authors.forename: Karen T
authors.initials: KT
authors.lastname: Brown
mesh_terms: D000328:Adult; D002404:Catheterization; D003287:Contrast Media; D004322:Drainage; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008197:Lymph Node Excision; D008210:Lymphocele / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000628:therapy*; D011206:Povidone-Iodine / Q000627:therapeutic use; D015641:Radiography, Interventional; D012597:Sclerosing Solutions / Q000627:therapeutic use; D015911:Sclerotherapy / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D014565:Urogenital Neoplasms / Q000473:pathology / Q000601:surgery
chemical_list: D003287:Contrast Media; D012597:Sclerosing Solutions; D011206:Povidone-Iodine