[Management of lymphatic fistulas in the groin from a surgeon's perspective].
BACKGROUND
The postoperative occurrence of lymph fistulas in the groin is a complication that should be taken seriously. These fistulas cause an increase in morbidity and can support local and ascending infections. The treatment of this complication ranges from conservative procedures, such as compression dressings and bed rest to operative treatment with detection of the fistulas and ligation, negative pressure wound therapy (NPWT) or even muscle flaps. This review provides an overview of current therapeutic modalities.


METHODS
On the basis of a current literature search via PubMed, we identified possible treatment options, which are described in this article.


RESULTS
The conservative treatment options presented still have an importance in treating groin fistulas. A selection of safe and effective interventional and operative treatments is presented.


CONCLUSIONS
If there are indications for an interventional or operative treatment a variety of safe and effective therapies are available, which can significantly reduce the length of hospital stay. The option of treatment using a muscle flap is of value as a last resort in the treatment of infected vascular prosthesis in the groin of Szilagyi type III and should be used when necessary.
Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Deutschland. benjamin.juntermanns@uk-essen.de.
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Juntermanns
Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Deutschland.
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Cyrek
Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Deutschland.
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Bernheim
Contilia Herz- und Gefäßzentrum, Klinik für Gefäßchirurgie und Phlebologie, Elisabeth-Krankenhaus Essen, Essen, Deutschland.
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Hoffmann
D000072700:Conservative Treatment; D005402:Fistula / Q000175:diagnosis / Q000601:surgery*; D006119:Groin / Q000601:surgery*; D006801:Humans; D008026:Ligation; D008206:Lymphatic Diseases / Q000175:diagnosis / Q000601:surgery*; D054843:Negative-Pressure Wound Therapy; D010043:Outcome and Process Assessment, Health Care; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery*; D012086:Reoperation / Q000379:methods*; D013524:Surgical Flaps
Conservative therapy; Groin lymphatic fistula; Lymphatic fistula; Negative pressure wound therapy; Surgical therapy