Technical Outcome, Clinical Success, and Complications of Low-Milliampere Computed Tomography Fluoroscopy-Guided Drainage of Lymphoceles Following Radical Prostatectomy with Pelvic Lymph Node Dissection.

Autor: D'Anastasi M; Medical Imaging Department, Mater Dei Hospital, University of Malta, MSD 2090 Msida, Malta.; Department of Radiology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany., Ebenberger S; Department of Radiology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany., Alghamdi A; Department of Urology, Albaha University, Albaha 65779-7738, Saudi Arabia.; Department of Urology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany., Helck A; Department of Radiology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany.; Radiology and Neuroradiology, Hirslanden Klinik Im Park, Seestrasse 220, 8027 Zürich, Switzerland., Herlemann A; Department of Urology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany., Stief C; Department of Urology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany., Khoder W; Department of Urology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany.; Department of Urology, Helios-Amper Klinikum Dachau, Krankenhausstraße 15, 85221 Dachau, Germany., Trumm CG; Institute for Diagnostic and Interventional Neuroradiology, University Hospital, LMU Munich, Campus Grosshadern, Marchioninistrasse 15, 81377 Munich, Germany., Stahl R; Institute for Diagnostic and Interventional Neuroradiology, University Hospital, LMU Munich, Campus Grosshadern, Marchioninistrasse 15, 81377 Munich, Germany.
Jazyk: angličtina
Zdroj: Diagnostics (Basel, Switzerland) [Diagnostics (Basel)] 2022 Oct 01; Vol. 12 (10). Date of Electronic Publication: 2022 Oct 01.
DOI: 10.3390/diagnostics12102394
Abstrakt: To evaluate the technical outcome, clinical success, and safety of low-milliampere CT fluoroscopy (CTF)-guided percutaneous drain (PD) placement in patients with lymphoceles following radical prostatectomy (RP) with pelvic lymph node dissection (LND). This retrospective analysis comprised 65 patients with PD placement in lymphoceles following RP under low-milliampere CTF guidance. Technical and clinical success were evaluated. Complications within a 30-day time interval associated with CTF-guided PD placement were classified according to SIR. Patient radiation exposure was quantified using dose-length products (DLP) of the pre-interventional planning CT scan (DLPpre), of the sum of intra-interventional CT fluoroscopic acquisitions (DLPintra) and of the post-interventional control CT scan (DLPpost). Eighty-nine lymphoceles were detected. Seventy-seven CT-guided interventions were performed, with a total of 92 inserted drains. CTF-guided lymphocele drainage was technically successful in 100% of cases. For all symptomatic patients, improvement in symptoms was reported within 48 h after intervention. Time course of C-reactive protein and Leucocytes within 30 days revealed a statistically significant (p < 0.0001) decrease. Median DLPpre, DLPintra and DLPpost were 431 mGy*cm, 45 mGy*cm and 303 mGy*cm, respectively. Only one minor complication (self-resolving haematoma over the bladder dome; SIR Grade 2) was observed. Low-milliampere CTF-guided drainage is a safe treatment option in patients with lymphoceles following RP with pelvic LND characterized by high technical and good clinical success rates, which provides rapid symptom relief and serves as definite treatment or as a bridging therapy prior to laparoscopic marsupialisation.
Databáze: MEDLINE
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