Uni- vs. multiloculated pelvic lymphoceles: differences in the treatment of symptomatic pelvic lymphoceles after open radical retropubic prostatectomy
| Autor: | Peter Breitling, Björn Haben, A. Treiyer, Joachim Steffens, Eberhard Stark |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2009 |
| Předmět: |
Male
medicine.medical_specialty Percutaneous Urology medicine.medical_treatment Lymphocele laparoscopy pelvis lcsh:RC870-923 prostatic neoplasms Pelvis lymph nodes Laparotomy Sclerotherapy medicine otorhinolaryngologic diseases Humans Postoperative Period lymphoceles Retrospective Studies Prostatectomy prostatectomy business.industry Prostatic Neoplasms lcsh:Diseases of the genitourinary system. Urology Marsupialization medicine.disease Antibiotic coverage Surgery Drainage Lymph Node Excision Laparoscopy business Radical retropubic prostatectomy Follow-Up Studies |
| Zdroj: | International braz j urol, Volume: 35, Issue: 2, Pages: 164-170, Published: APR 2009 International braz j urol v.35 n.2 2009 International Braz J Urol Sociedade Brasileira de Urologia (SBU) instacron:SBU International Brazilian Journal of Urology, Vol 35, Iss 2, Pp 164-170 (2009) |
| Popis: | PURPOSE: To evaluate the treatment of symptomatic pelvic lymphoceles (SPL) after performing radical retropubic prostatectomy (RRP) and pelvic lymphadenectomy (PLA) simultaneously. MATERIAL AND METHODS:We analyzed, in a retrospective study, 250 patients who underwent RRP with PLA simultaneously. Only patients with SPL were treated using different non- and invasive procedures such as percutaneous aspiration, percutaneous catheter drainage (PCD) with or without sclerotherapy, laparoscopic lymphocelectomy (LL) and open marsupialization (OM). RESULTS: Fifty-two patients (21%) had postoperative subclinical pelvic lymphoceles. Thirty patients (12%) developed SPL. Fifteen patients with noninfected uniloculated lymphocele (NUL) healed spontaneously after performing PCD. The remaining seven patients required sclerotherapy with additional doxycycline. After performing PCD, NUL healed better and faster than noninfected multiloculated lymphocele (NML) (success rate: 80% vs. 16%, respectively). Twenty-seven percent of patients treated initially with PCD, with or without sclerotherapy had persistent lymphocele. All patients were successfully treated with LL. Only one patient had an abscess as a major complication of a persistent SPL after PCD and sclerotherapy and was treated via an open laparotomy. CONCLUSIONS: Symptomatic NUL can be treated using PCD with or without sclerotherapy. If this therapy fails as first-line treatment, laparoscopic lymphocelectomy should be considered within a short period of time in order to achieve successful treatment. NML should be treated using a laparoscopic approach in centers where this type of expertise is available. Infected lymphoceles are drained externally. In these cases, percutaneous or open external drainage with adequate antibiotic coverage is preferable. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|