Year 2020, Volume 21 , Issue 2, Pages 141 - 149 2020-05-11

PERCUTANEOUS TREATMENT OF LYMPHOCELE: COMPARISON OF SINGLE AND MULTIPLE SESSIONS SCLEROTHERAPY
LENFOSELLERDE PERKÜTAN TEDAVİ: TEK VEYA ÇOK SEANS SKLEROTERAPİNİN ETKİNLİĞİNİN KARŞILAŞTIRILMASI

Ömür BALLI [1] , Okan AKHAN [2] , Devrim AKINCI [3] , Türkmen ÇİFTÇİ [4]


OBJECTIVE: Percutaneous transcatheter sclerotherapy technique has been used as a first- line theraphy for treatment of postoperative pelvic lymphocele for long years. The aim of this prospective-randomized study is to investigate and compare the therapeutic efficacy, reliability, major and minor complications, short and long-term results of single and multisession percutaneous transcatheter ethanol sclerotherapy.
MATERIAL AND METHODS: Between August 2002 and February 2010, 19 patients who had postoperative symptomatic pelvic lymphocele were included in this study. All of them were female and the mean age of patients was 52.5 (range:25-75) years.
RESULTS: 12 (46%) of them were treated with single-session of ethanol sclerotherapy and 14 (54%) of them were treated with multi-session of ethanol sclerotherapy. Recurrence developed in 3 (25%) lymphoceles treated by single-session and 1 (7%) lymphocele treated by multiple- session percutaneous transcatheter ethanol sclerotherapy. Also, abscess developed in 2 (14%) lymphoceles after multiple-session percutaneous transcatheter ethanol sclerotherapy. All of the recurrent lymphoceles were treated by multiple-session percutaneous transcatheter ethanol sclerotherapy and abscesses were treated by percutaneous catheter drainage with appropriate antibiotic medication. Totally, 30 sclerotherapy procedures were performed. The mean duration of percutaneous catheter drainage was 21 days (4–55 days). There was no statistically difference between single and multi-session techniques for sclerotherapy of lymphocele (p=0.270). The follow-up period ranged from 1 to 96 months (mean:21 months).
CONCLUSIONS: As a result, the treatment of lymphocele with single-session sclerotherapy is a safe and effective procedure, however, in recurrent lymphoceles, multisession sclerotherapy may be the treatment of choice.

AMAÇ: Lenfosel tedavisinde perkütan trankateter skleroterapi tekniği uzun yıllardan beri ilk tedavi seçeneği olarak kullanılmaktadır. Bu prospektif randomize çalışmanın amacı tek veya çok seans etanol skleroterapisinin başarı oranlarını, güvenilirlik düzeyini, major ve minor komplikasyonlarını, kısa ve uzun dönem takip sonuçlarını karşılaştırmalı olarak değerlendirmektir.
GEREÇ VE YÖNTEM: Ağustos 2002 – Şubat 2010 tarihleri arasında postoperatif semptomatik pelvik lenfoseli olan 19 hasta çalışmaya dahil edildi. Hastaların tamamı kadın olup, ortalama yaşları 52.5 (25-75) idi.
BULGULAR: Hastalarda mevcut bulunan 26 lenfoselin 12 (%46) tanesine tek seans, 14 (%54) tanesine çok seans skleroterapi işlemi uygulandı. Tek seans işlem sonrası 3 (%25) lenfoselde rekürrens, çok seans sonrası ise 1 (%7) lenfoselde rekürrens ve 2 (%14) lenfoselde apse izlendi. 4 rekürren lenfosele çok seans skleroterapi, apselere ise perkütan kateter drenajı yapılıp, uygun antibiyotik verilerek tedavi edildi. Bu işlemlerle birlikte toplam 30 perkütan transkateter etanol skleroterapi işlemi gerçekleştirildi. Çok seans uygulanan hastalarda, ortalama kateterizasyon süresi 21 (4-55) gündü. Hastaların takip süresi ortalama 21 (1- 96 ay) aydı. İstatistiksel çalışmalarda tek veya çok seans skleroterapi teknikleri arasında anlamlı fark saptanmadı (p=0.270).
SONUÇ: Lenfosel tedavisinde tek seans etanol skleroterapi işlemi ilk seçenek olarak etkin ve güvenilir olup, rekürrenslerde ise çok seans skleroterapi tercih edilebilecek tedavi yöntemidir.

  • 1. Conte M, Panici PB, Guariglia L, Scambia G, Greggi S, Mancuso S. Pelvic lymphocele following radical para-aortic and pelvic lymphadenectomy for cervical carcinoma: incidence rate and percutaneous management. Obstet Gynecol. 1990;76:268–71.
  • 2. McDougall EM, Clayman R V. Endoscopic management of persistent lymphocele following laparoscopic pelvic lymphadenectomy. Urology. Elsevier; 1994;43:404–7.
  • 3. Gruessner RWG, Fasola C, Benedetti E, Foshager MC, Gruessner AC, Matas AJ, et al. Laparoscopic drainage of lymphoceles after kidney transplantation: indications and limitations. Surgery. Elsevier; 1995;117:288–95.
  • 4. Itkin M. Lymphatic Intervention Techniques: Look Beyond Thoracic Duct Embolization. J Vasc Interv Radiol [Internet]. Elsevier; 2016;27:1187–8. Available from: http://dx.doi.org/10.1016/j.jvir.2016.05.038
  • 5. Lee EW, Shin JH, Ko HK, Park J, Kim SH, Sung KB. Lymphangiography to treat postoperative lymphatic leakage: A technical review. Korean J Radiol. 2014;15:724–32.
  • 6. Smolock AR, Nadolski G, Itkin M. Intranodal Glue Embolization for the Management of Postsurgical Groin Lymphocele and Lymphorrhea. J Vasc Interv Radiol [Internet]. SIR; 2018;29:1462–5. Available from: https://doi.org/10.1016/j.jvir.2018.04.020
  • 7. Baek Y, Won JH, Chang SJ, Ryu HS, Song SY, Yim B, et al. Lymphatic Embolization for the Treatment of Pelvic Lymphoceles: Preliminary Experience in Five Patients. J Vasc Interv Radiol [Internet]. Elsevier; 2016;27:1170–6. Available from: http://dx.doi.org/10.1016/j.jvir.2016.04.011
  • 8. Hur S, Shin JH, Lee IJ, Min SK, Min S Il, Ahn S, et al. Early Experience in the Management of Postoperative Lymphatic Leakage Using Lipiodol Lymphangiography and Adjunctive Glue Embolization. J Vasc Interv Radiol [Internet]. Elsevier; 2016;27:1177–1186.e1. Available from: http://dx.doi.org/10.1016/j.jvir.2016.05.011
  • 9. Melvin WS, Bumgardner GL, Davies EA, Elkhammas EA, Henry ML, Ferguson RM. The laparoscopic management of post-transplant lymphocele. Surg Endosc. Springer; 1997;11:245–8.
  • 10. Lucey BC, Kuligowska E. Radiologic management of cysts in the abdomen and pelvis. Am J Roentgenol. 2006;186:562–73.
  • 11. Aronowitz J, Kaplan AL. The management of a pelvic lymphocele by the use of a percutaneous indwelling catheter inserted with ultrasound guidance. Gynecol Oncol. Elsevier; 1983;16:292–5.
  • 12. Teruel JL, Escobar EM, Quereda C, Mayayo T, Ortuno J. A simple and safe method for management of lymphocele after renal transplantation. J Urol. Elsevier; 1983;130:1058–9.
  • 13. Petru E, Tamussino K, Lahousen M, Winter R, Pickel H, Haas J. Pelvic and paraaortic lymphocysts after radical surgery because of cervical and ovarian cancer. Am J Obstet Gynecol. Elsevier; 1989;161:937–41.
  • 14. Sawhney R, D’Agostino HB, Zinck S, Rose SC, Kinney TB, Oglevie SB, et al. Treatment of postoperative lymphoceles with percutaneous drainage and alcohol sclerotherapy. J Vasc Interv Radiol. Elsevier; 1996;7:241–5.
  • 15. Zuckerman DA, Yeager TD. Percutaneous ethanol sclerotherapy of postoperative lymphoceles. AJR Am J Roentgenol. Am Roentgen Ray Soc; 1997;169:433–7.
  • 16. Chin AI, Ragavendra N, Hilborne L, Gritsch HA. Fibrin sealant sclerotherapy for treatment of lymphoceles following renal transplantation. J Urol. 2003;170:380–3.
  • 17. Akhan O, Cekirge S, Özmen M, Besim A. Percutaneous transcatheter ethanol sclerotheraphy of postoperative pelvic lymphoceles. Cardiovasc Intervent Radiol. Springer; 1992;15:224–7.
  • 18. Akhan O, Karcaaltincaba M, Ozmen MN, Akinci D, Karcaaltincaba D, Ayhan A. Percutaneous transcatheter ethanol sclerotherapy and catheter drainage of postoperative pelvic lymphoceles. Cardiovasc Intervent Radiol. 2007;30:237–40.
  • 19. Längle F, Schurawitzki H, Mühlbacher F, Steininger R, Watschinger B, Derfler K, et al. Treatment of lymphoceles following renal transplantation. Transplant Proc. 1990. p. 1420.
  • 20. Pollak R, Veremis SA, Maddux MS, Mozes MF. The natural history of and therapy for perirenal fluid collections following renal transplantation. J Urol. Elsevier; 1988;140:716–20.
  • 21. Olsson CA, Willscher MK, Filoso AM, Cho SI. Treatment of posttransplant lymphoceles: internal versus external drainage. Transplant Proc. 1976. p. 501–4.
  • 22. Hsu THS, Gill IS, Grune MT, Andersen R, Eckhoff D, Goldfarb DA, et al. Laparoscopic lymphocelectomy: a multi-institutional analysis. J Urol. Elsevier; 2000;163:1096–9.
  • 23. Karcaaltincaba M, Akhan O. Radiologic imaging and percutaneous treatment of pelvic lymphocele. Eur J Radiol. 2005;55:340–54.
  • 24. Kay R, Fuchs E, Barry JM. Management of postoperative pelvic lymphoceles. Urology. Elsevier; 1980;15:345–7.
  • 25. Jensen SR, Voegeli DR, McDermott JC, Crummy AB. Percutaneous management of lymphatic fluid collections. Cardiovasc Intervent Radiol. Springer; 1986;9:202–4.
  • 26. Mahrer A, Ramchandani P, Trerotola SO, Shlansky-Goldberg RD, Itkin M. Sclerotherapy in the Management of Postoperative Lymphocele. J Vasc Interv Radiol [Internet]. Elsevier Inc.; 2010;21:1050–3. Available from: http://dx.doi.org/10.1016/j.jvir.2010.03.014
  • 27. Król R, Kolonko A, Chudek J, Ziaja J, Pawlicki J, Mały A, et al. Did Volume of Lymphocele After Kidney Transplantation Determine the Choice of Treatment Modality? Transplant Proc. 2007;39:2740–3.
  • 28. Tasar M, Gulec B, Saglam M, Yavuz I, Bozlar U, Ugurel S. Posttransplant symptomatic lymphocele treatment with percutaneous drainage and ethanol sclerosis: Long-term follow-up. Clin Imaging. 2005;29:109–16.
  • 29. Simonetti G, Profili S, Sergiacomi GL, Meloni GB, Orlacchio A. Percutaneous treatment of hepatic cysts by aspiration and sclerotherapy. Cardiovasc Intervent Radiol. Springer; 1993;16:81–4.
  • 30. Paananen I, Hellström P, Leinonen S, Merikanto J, Perälä J, Päivänsalo M, et al. Treatment of renal cysts with single-session percutaneous drainage and ethanol sclerotherapy: long-term outcome. Urology. Elsevier; 2001;57:30–3.
  • 31. Bozkurt FB, Boyvat F, Tekin I, Aytekin C, Coskun M, Ozkardes H. Percutaneous sclerotherapy of a giant benign renal cyst with alcohol. Eur J Radiol. Elsevier; 2001;40:64–7.
  • 32. Gasparini D, Sponza M, Valotto C, Marzio A, Luciani LG, Zattoni F. Renal cysts: can percutaneous ethanol injections be considered an alternative to surgery? Urol Int. Karger Publishers; 2003;71:197–200.
  • 33. Rivera M, Marcén R, Burgos J, Arranz M, Rodriguez R, Teruel JL, et al. Treatment of Posttransplant Lymphocele with Povidone-lodine Sclerosis: Long-Term Follow-Up. Nephron. Karger Publishers; 1996;74:324–7.
Primary Language tr
Subjects Medicine
Published Date NİSAN 2020
Journal Section Articles
Authors

Author: Ömür BALLI (Primary Author)
Institution: İZMİR KATİP ÇELEBİ ÜNİVERSİTESİ ATATÜRK EĞİTİM VE ARAŞTIRMA HASTANESİ, GİRİŞİMSEL RADYOLOJİ KLİNİĞİ
Country: Turkey


Author: Okan AKHAN
Institution: HACETTEPE ÜNİVERSİTESİ, TIP FAKÜLTESİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, RADYOLOJİ ANABİLİM DALI
Country: Turkey


Author: Devrim AKINCI
Institution: HACETTEPE ÜNİVERSİTESİ, TIP FAKÜLTESİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, RADYOLOJİ ANABİLİM DALI

Author: Türkmen ÇİFTÇİ
Institution: HACETTEPE ÜNİVERSİTESİ, TIP FAKÜLTESİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, RADYOLOJİ ANABİLİM DALI

Dates

Publication Date : May 11, 2020

Bibtex @research article { kocatepetip503394, journal = {Kocatepe Tıp Dergisi}, issn = {1302-4612}, eissn = {2149-7869}, address = {}, publisher = {Afyonkarahisar Sağlık Bilimleri Üniversitesi}, year = {2020}, volume = {21}, pages = {141 - 149}, doi = {10.18229/kocatepetip.503394}, title = {LENFOSELLERDE PERKÜTAN TEDAVİ: TEK VEYA ÇOK SEANS SKLEROTERAPİNİN ETKİNLİĞİNİN KARŞILAŞTIRILMASI}, key = {cite}, author = {Ballı, Ömür and Akhan, Okan and Akıncı, Devrim and Çi̇ftçi̇, Türkmen} }
APA Ballı, Ö , Akhan, O , Akıncı, D , Çi̇ftçi̇, T . (2020). LENFOSELLERDE PERKÜTAN TEDAVİ: TEK VEYA ÇOK SEANS SKLEROTERAPİNİN ETKİNLİĞİNİN KARŞILAŞTIRILMASI . Kocatepe Tıp Dergisi , 21 (2) , 141-149 . DOI: 10.18229/kocatepetip.503394
MLA Ballı, Ö , Akhan, O , Akıncı, D , Çi̇ftçi̇, T . "LENFOSELLERDE PERKÜTAN TEDAVİ: TEK VEYA ÇOK SEANS SKLEROTERAPİNİN ETKİNLİĞİNİN KARŞILAŞTIRILMASI" . Kocatepe Tıp Dergisi 21 (2020 ): 141-149 <https://dergipark.org.tr/en/pub/kocatepetip/issue/54261/503394>
Chicago Ballı, Ö , Akhan, O , Akıncı, D , Çi̇ftçi̇, T . "LENFOSELLERDE PERKÜTAN TEDAVİ: TEK VEYA ÇOK SEANS SKLEROTERAPİNİN ETKİNLİĞİNİN KARŞILAŞTIRILMASI". Kocatepe Tıp Dergisi 21 (2020 ): 141-149
RIS TY - JOUR T1 - LENFOSELLERDE PERKÜTAN TEDAVİ: TEK VEYA ÇOK SEANS SKLEROTERAPİNİN ETKİNLİĞİNİN KARŞILAŞTIRILMASI AU - Ömür Ballı , Okan Akhan , Devrim Akıncı , Türkmen Çi̇ftçi̇ Y1 - 2020 PY - 2020 N1 - doi: 10.18229/kocatepetip.503394 DO - 10.18229/kocatepetip.503394 T2 - Kocatepe Tıp Dergisi JF - Journal JO - JOR SP - 141 EP - 149 VL - 21 IS - 2 SN - 1302-4612-2149-7869 M3 - doi: 10.18229/kocatepetip.503394 UR - https://doi.org/10.18229/kocatepetip.503394 Y2 - 2019 ER -
EndNote %0 Kocatepe Tıp Dergisi LENFOSELLERDE PERKÜTAN TEDAVİ: TEK VEYA ÇOK SEANS SKLEROTERAPİNİN ETKİNLİĞİNİN KARŞILAŞTIRILMASI %A Ömür Ballı , Okan Akhan , Devrim Akıncı , Türkmen Çi̇ftçi̇ %T LENFOSELLERDE PERKÜTAN TEDAVİ: TEK VEYA ÇOK SEANS SKLEROTERAPİNİN ETKİNLİĞİNİN KARŞILAŞTIRILMASI %D 2020 %J Kocatepe Tıp Dergisi %P 1302-4612-2149-7869 %V 21 %N 2 %R doi: 10.18229/kocatepetip.503394 %U 10.18229/kocatepetip.503394
ISNAD Ballı, Ömür , Akhan, Okan , Akıncı, Devrim , Çi̇ftçi̇, Türkmen . "LENFOSELLERDE PERKÜTAN TEDAVİ: TEK VEYA ÇOK SEANS SKLEROTERAPİNİN ETKİNLİĞİNİN KARŞILAŞTIRILMASI". Kocatepe Tıp Dergisi 21 / 2 (May 2020): 141-149 . https://doi.org/10.18229/kocatepetip.503394
AMA Ballı Ö , Akhan O , Akıncı D , Çi̇ftçi̇ T . LENFOSELLERDE PERKÜTAN TEDAVİ: TEK VEYA ÇOK SEANS SKLEROTERAPİNİN ETKİNLİĞİNİN KARŞILAŞTIRILMASI. KTD. 2020; 21(2): 141-149.
Vancouver Ballı Ö , Akhan O , Akıncı D , Çi̇ftçi̇ T . LENFOSELLERDE PERKÜTAN TEDAVİ: TEK VEYA ÇOK SEANS SKLEROTERAPİNİN ETKİNLİĞİNİN KARŞILAŞTIRILMASI. Kocatepe Tıp Dergisi. 2020; 21(2): 141-149.