title: Effective treatment of pelvic lymphocele by lymphaticovenular anastomosis.
abstract: OBJECTIVE
  Pelvic lymphocele can be a severe complication associated with surgical procedures such as pelvic lymphadenectomy. Lymphaticovenular anastomosis (LVA) is increasing in popularity as a surgical treatment for lymphedema. The aim of this study was to evaluate whether LVA is an effective treatment for lymphocele, which is caused by an obstruction of the lymphatic flow in a manner similar to the development of lymphedema.
  
  
  METHODS
  Eleven female patients, who presented with lymphocele, were treated with LVA. Before the operation, 3 of them were treated with a percutaneous catheter. Lymphocele size and the volume of daily drainage were measured before and after LVA.
  
  
  RESULTS
  The lymphocele was completely resolved in 6 patients and partially resolved in the remaining 5 patients. The mean size of the pelvic lymphocele changed from 400 ml (range 50-1050 ml) to 43 ml (range 0-120 ml) (P<0.01). In the 3 patients who had percutaneous drainage catheters, the volume of fluid drained decreased from 340 ml/day to 20 ml/day after LVA.
  
  
  CONCLUSIONS
  Our technique is minimally invasive and is performed under local anesthesia. LVA is effective regardless of the size of the lymphocele. Therefore, LVA should be considered as a therapy for lymphocele because of its low invasiveness and its effectiveness in re-establishing circulation of lymphatic flow. Further studies should be performed to compare LVA with other minimally invasive techniques, such as percutaneous catheter and sclerotherapy.
authors.affiliation: Department of Plastic and Reconstructive Surgery, The University of Tokyo, Tokyo, Japan. todokoro-tky@umin.ac.jp
authors.forename: Takeshi
authors.initials: T
authors.lastname: Todokoro
authors.forename: Dominic
authors.initials: D
authors.lastname: Furniss
authors.forename: Katsutoshi
authors.initials: K
authors.lastname: Oda
authors.forename: Kei
authors.initials: K
authors.lastname: Kawana
authors.forename: Mitsunaga
authors.initials: M
authors.lastname: Narushima
authors.forename: Makoto
authors.initials: M
authors.lastname: Mihara
authors.forename: Kazuki
authors.initials: K
authors.lastname: Kikuchi
authors.forename: Hisako
authors.initials: H
authors.lastname: Hara
authors.forename: Tetsu
authors.initials: T
authors.lastname: Yano
authors.forename: Isao
authors.initials: I
authors.lastname: Koshima
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods*; D005260:Female; D005833:Genital Neoplasms, Female / Q000601:surgery; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects; D008210:Lymphocele / Q000209:etiology / Q000601:surgery*; D008875:Middle Aged; D010388:Pelvis