A case of laparoscopic fenestration surgery for pelvic lymphocele occurring after laparoscopic radical prostatectomy

Abstract

A 76-year-old Japanese man visited a nearby medical clinic complaining of abdominal distention. He had undergone extraperitoneal laparoscopic prostatectomy at our institution 5 months before the onset of abdominal distention. An imaging study revealed a large cystic lesion, and biochemical examination of a sample obtained via cyst puncture led to a diagnosis of lymphocele. As the lymphocele was resistant to puncture, drainage, and sclerotherapy with minomycin, laparoscopic fenestration was performed. Although the patient developed an adhesive ileus postoperatively, the cyst has not recurred. Fenestration surgery is a feasible option for lymphocele refractory to various conservative therapies.

Resolution of large pelvic lymphocele after incidental intracystic hemorrhage caused by percutaneous catheter drainage: Case report

“…3,4 Laparoscopic marsupialization is also an option. 5 To identify and embolize lymph leakage, lymphangiography using indocyanine green or ethiodized oil is effective. 6,7 A systematic review 8 showed proportions of successful interventions for percutaneous catheter drainage, percutaneous catheter drainage with the addition of sclerotherapy, and embolization: 0.612 (95% confidence interval [CI]: 0.490-0.722), 0.890 (95% CI: 0.781-0.948), and 0.922 (95% CI: 0.731-0.981), respectively.…”

“…When it is refractory to conservative treatment, we need to consider surgical therapies, such as embolization of the leaking lymphatic ducts, lymphatic microsurgery (lymphatic ligation, lymphovenous or lympholymphatic anastomosis) 3,4 . Laparoscopic marsupialization is also an option 5 . To identify and embolize lymph leakage, lymphangiography using indocyanine green or ethiodized oil is effective 6,7 .…”