Comparative Analysis of Intranodal Lymphangiography with Percutaneous Intervention for Postsurgical Chylous Effusions

Yannes, Michael; Shin, Donghoon; McCluskey, Kevin; Varma, Rakesh; Santos, Ernesto

doi:10.1016/j.jvir.2016.12.1209

Cited by 45 publications

(40 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…42,43 Due to his work, TDE has become the preferred intervention for the treatment of chylothorax and this procedure is supported by multiple studies. [43][44][45] After the development of INL in 2011, 23 there has been a revival of the lymphatic interventions and expansion of the lymphatic embolization approaches. This development has allowed treating hepatic lymphorrhea, protein loosing enteropathy, and CA.…”

Section: Lymphatic Interventions In Patients With Chylous Ascitesmentioning

confidence: 99%

Chylous Ascites and Lymphoceles: Evaluation and Interventions

Santos

Moussa

2020

Semin intervent Radiol

Self Cite

View full text Add to dashboard Cite

Kinmonth introduced lymphangiography in 1955 and it became an important tool in the diagnosis and treatment of malignant disease. The technique, based on bipedal approach, was difficult and time-consuming which limited its use in clinical practice. Cope is the father of percutaneous lymphatic interventions and he was the first person to access and intervene on the lymphatic system. After his initial work published on 1999, there has been an expansion of the lymphatic embolization techniques, particularly since the development of intranodal lymphangiography and advance lymphatic imaging. This article is focused on the evaluation and management of postoperative chylous ascites and lymphoceles. Their incidence is growing due to longer survival of cancer patients and more radical surgical approaches, leading to an increased morbidity and mortality in this patient population. Minimally invasive percutaneous lymphatic embolization is becoming a first-line therapy in patients with postoperative lymphatic leakage.

show abstract

Section: Lymphatic Interventions In Patients With Chylous Ascitesmentioning

confidence: 99%

Chylous Ascites and Lymphoceles: Evaluation and Interventions

Santos

Moussa

2020

Semin intervent Radiol

Self Cite

View full text Add to dashboard Cite

show abstract

“…Surgical management comprises different and at least in parts non-standardized approaches such as lymph duct ligation, shunt implantation, sclerotherapy with doxycycline or thrombin, plastic surgery, and wound vacuum therapy [6,7]. Depending on the type, degree and location of PLL, both conservative and surgical management can be challenging to perform, time-consuming and expensive as well as clinically ineffective, whereby surgery-related complication and mortality rates of up to 38 % and 25 %, respectively, have been described [1,3,4,6,[8][9][10][11][12][13]. Conventional lymphangiography (CL), a radiological examination performed under X-ray imaging after contrast material injection, has emerged as an alternative to the aforementioned treatments.…”

Section: Introductionmentioning

confidence: 99%

Conventional Lymphangiography (CL) in the Management of Postoperative Lymphatic Leakage (PLL): A Systematic Review

Sommer

Pieper

Itkin³

et al. 2020

Rofo

View full text Add to dashboard Cite

Background Postoperative lymphatic leakage (PLL) is usually managed by conservative and/or surgical treatments but these procedures can be challenging to perform and potentially clinically ineffective. Therefore, conventional lymphangiography (CL) has emerged as an important alternative. The aim of this review is to present the available outcome data on CL in the management of PLL. Method A systematic literature search (PubMed) using the MeSH term “lymphangiography” was performed and the search was restricted to literature published between January 2007 and August 2019. Identification, screening, and assessment for eligibility and inclusion were conducted in accordance with PRISMA. Results From the initially obtained 1006 articles (identification), 28 articles with a total of 201 patients were finally included (inclusion). The methodological quality of all included articles corresponds to level 4 (Oxford Centre for Evidence-based Medicine – Levels of Evidence, March 2009). PLL occurs after oncological and non-oncological surgery in the form of chylothorax, chylous ascites, and cervical, thoracic, abdominal and peripheral lymph fistula and/or lymphocele. The technical success rate of CL is 75–100 %. Access for CL is transpedal (176 patients) or intranodal (25 patients). Lipiodol is used as the contrast material in all articles, with a maximum amount of 20 ml for transpedal CL and 30 ml for intranodal CL. The X-ray imaging modalities used for CL are fluoroscopy, radiography and/or CT. Two articles report CL-associated major complications and CL-associated morbidity and mortality. The PLL cure rate is 51–70 % for transpedal CL (time to PLL cure: 2–29 days) and 33–100 % for intranodal CL (time to PLL cure: 2–< 30 days). Bailout procedures in the case of clinically ineffective CL include a range of treatments. Conclusion CL is feasible, safe, and effective in the management of PLL. Lipiodol as the contrast material is essential in CL because the highly viscous iodinated poppy-seed oil has not only diagnostic but therapeutic effects. Guidelines and randomized controlled trials are further steps towards defining the ultimate value of CL. Key Points: Citation Format

show abstract

“…26 Subsequently, several large series from multiple medical centers have reported similarly promising results. 27,28 A 2018 meta-analysis comprising nine studies and over 400 patients revealed a more than 80% clinical success rate of TDE for chylothorax and a more than 50% clinical success rate of lymphangiography for chylothorax. 29 TDE for pediatric chylothorax (children ages ranging from 2 weeks to 17 years) has also been reported, albeit in smaller series compared with adult cohorts.…”

Section: Discussionmentioning

confidence: 99%

Traumatic Chylothorax: Approach and Outcomes

Gilyard

Khaja

Goswami

et al. 2020

Semin intervent Radiol

View full text Add to dashboard Cite

Traumatic chylothorax occurs more often now than in historic reports. In part, this is due to the increased ability to perform more advanced and aggressive thoracic resections and cardiovascular surgeries as well as the improved mortality of cancer patients. If untreated, chylothorax can result in significant morbidity and mortality, particularly in patients with underlying malignancy. Thoracic duct embolization for chylothorax was the first successful lymphatic intervention and has been performed for over 20 years. An overview of the clinical and technical approach to thoracic duct embolization for traumatic chylothorax is presented in addition to a review of outcomes.

show abstract

Comparative Analysis of Intranodal Lymphangiography with Percutaneous Intervention for Postsurgical Chylous Effusions

Cited by 45 publications

References 25 publications

Chylous Ascites and Lymphoceles: Evaluation and Interventions

Chylous Ascites and Lymphoceles: Evaluation and Interventions

Conventional Lymphangiography (CL) in the Management of Postoperative Lymphatic Leakage (PLL): A Systematic Review

Traumatic Chylothorax: Approach and Outcomes

Contact Info

Product

Resources

About