Abstract
PurposeA broad range of therapeutic options exists for symptomatic postoperative lymphoceles. However, no consensus exists on what is the optimal therapy. In this study, we aimed to compare the efficacy of currently available radiologic interventions in terms of number of successful interventions, number of recurrences, and number of complications. MethodsA systematic review was conducted with a pre-defined search strategy for PubMed, EMBASE, and Cochrane databases from inception until September 2019. Quality assessment was performed using the ‘Risk Of Bias In Non-randomized Studies - of Interventions’ tool. Statistical heterogeneity was assessed using the I2 and χ2 test and a meta-analysis was considered for studies reporting on multiple interventions. Results37 eligible studies including 732 lymphoceles were identified. Proportions of successful interventions for percutaneous fine needle aspiration, percutaneous catheter drainage, percutaneous catheter drainage with delayed or instantaneous addition of sclerotherapy, and embolization were as follows: 0.341 (95% confidence interval [CI]: 0.185−0.542), 0.612 (95% CI: 0.490−0.722), 0.890 (95% CI: 0.781−0.948), 0.872 (95% CI: 0.710−0.949), 0.922 (95% CI: 0.731−0.981). Random-effects meta-analysis of seven studies revealed a pooled relative risk for percutaneous catheter drainage with delayed addition of sclerotherapy of 1.57 (95% CI: 1.17–2.10) when compared to percutaneous catheter drainage alone. The risk of bias in this study was severe. ConclusionsThis systematic review demonstrates that the success rates of percutaneous catheter drainage with sclerotherapy are more favorable when compared to percutaneous catheter drainage alone in the treatment of postoperative pelvic lymphoceles. Overall, percutaneous catheter drainage with delayed addition of sclerotherapy, and embolization showed the best outcomes.
Highlights
A notorious complication of pelvic surgery is the formation of a lymphocele
Of the studies that were selected for the review, 21 were case series, 13 were retrospective cohort studies, and three were prospective cohort studies. 11 studies involved lymphoceles after gynecologic oncologic surgery, three after urologic oncologic surgery, and 19 after renal transplantation
Most individual lymphoceles were found in patients with percutaneous catheter drainage (n=330)
Summary
A notorious complication of pelvic surgery is the formation of a lymphocele. This is a collection of lymphatic fluid surrounded by a thin fibrotic wall that lacks epithelial lining. Termed lymphocysts, may occur after surgical procedures in which lymph ves sels are disrupted, either by truncation or inadequate ligation [1,2,3,4,5]. Surgical evacuation with fenestration or marsupialization, initially via laparotomy and later on via laparoscopy, was once considered the treatment of choice [9,10,11]. Lymphoceles are pri marily treated with percutaneous catheter drainage. Other treatment options include percutaneous fine needle aspiration, and embolization
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
