Povidone-iodine sclerotherapy of primary symptomatic lymphocele after kidney transplantation

Baboudjian, Michael; Tadrist, Abel; Gondran-Tellier, Bastien; McManus, Robin; Akiki, Akram; Gaillet, S.; Delaporte, V.; Carballeira, Ana; André, Marc; Karsenty, G.; Lechevallier, É.; Boissier, R.

doi:10.1007/s11255-020-02709-2

Cited by 7 publications

(4 citation statements)

References 18 publications

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“…There was no report of sclerosant extravasation, which is the most serious complication reported in the literature. 5 , 7 , 10 , 11 , 19 , 20 , 21 The complication rate with LE was higher than the sclerotherapy group (26.4%) but not statistically significant, and it was slightly higher than in other studies (8%–20%). 9 , 14 Most adverse events noted with LE were related to the drain occlusion having to be exchanged, which is why the authors advocate for exchanging the drainage catheter after LE in the same session.…”

Section: Discussioncontrasting

confidence: 54%

A comparison of lymphatic embolization and sclerotherapy in the management of iatrogenic abdominopelvic lymphoceles following oncological surgery

Moussa¹,

Aly²,

Maybody³

et al. 2023

dir

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PURPOSE To compare the safety and efficacy of sclerotherapy and lymphatic embolization (LE) in the treatment of symptomatic iatrogenic lymphoceles following the placement of a percutaneous drainage catheter. METHODS This is a retrospective study of 46 patients who underwent sclerotherapy (17 patients) or LE (29 patients) for the management of symptomatic iatrogenic lymphoceles following percutaneous drain placement between January 2017 and December 2021. The demographic characteristics, time between surgery and lymphatic intervention, clinical presentation, number of procedures, drain output pre- and post-intervention, time from intervention to drain removal, and adverse events were collected and compared for both groups. The clinical success rate, defined as the successful removal of the drain after one procedure, was calculated. Adverse events were reported according to the Society of Interventional Radiology classification. A statistical analysis was conducted using SPSS, and the P value for statistical significance was set at 0.05. The Mann–Whitney U test was used to compare differences in the scale variables, and Fisher’s exact test was used to compare the categorical and ordinal variables between both groups. RESULTS A total of 46 patients with 49 lymphoceles met the inclusion criteria of the study. Of these patients, 17 patients (19 lymphoceles) underwent sclerotherapy, and 29 patients (30 lymphoceles) underwent LE as their initial procedures. The clinical success after one procedure was significantly higher (83% vs. 47%, P = 0.011), and the median time between the first intervention and drain removal was significantly shorter in the LE group (median duration of 6 vs. 13 days, P = 0.018) compared with the sclerotherapy group. No statistically significant difference in adverse events was noted between both groups (0.26 vs. 0.10, P = 0.11). CONCLUSION This study found that LE had a higher clinical success rate after the first procedure and a shorter time to drain removal compared with sclerotherapy. There was no difference in the rate of adverse events between both groups. Although LE is a safe and promising technique, a prospective study is needed to further compare the efficacy of both treatment modalities.

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Section: Discussioncontrasting

confidence: 54%

A comparison of lymphatic embolization and sclerotherapy in the management of iatrogenic abdominopelvic lymphoceles following oncological surgery

Moussa¹,

Aly²,

Maybody³

et al. 2023

dir

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“…Furthermore, central lymphoceles should only be sclerosed when leakage into the abdominal cavity is excluded. Otherwise complication rates are low with possible local infection and pain 192,193,195 …”

Section: Therapeutic Approaches To Lymphatic Diseasesmentioning

confidence: 99%

“…190 The aim of sclerotherapy is the induction of an inflammatory reaction within the lymphocele with subsequent healing. Although there is still no standardized approach in respect of sclerosing agent (eg, OK-432, ethanol, povidone iodine, doxycycline, bleomycin) as well as volume, timing, and number of sclerosing sessions, 41,136,[191][192][193][194] healing can be faster than with conservative measures alone. However, often repeated sclerotherapy sessions are necessary.…”

Section: Peripheral Lymphatic Fistula and Lymphocelesmentioning

confidence: 99%

“…Otherwise complication rates are low with possible local infection and pain. 192,193,195 More recently, XRL-pedal or nodal depending on the location of leakage-is increasingly used in targeted treatment of peripheral lymphatic fistula and lymphoceles. As discussed previously, ethiodized oil-based XRL can already have a therapeutic effect, which, however, typically takes a few days or even weeks to set in.…”

Section: Peripheral Lymphatic Fistula and Lymphocelesmentioning

confidence: 99%

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Back to the Future II—A Comprehensive Update on the Rapidly Evolving Field of Lymphatic Imaging and Interventions

Pieper

2023

Invest Radiol

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Lymphatic imaging and interventional therapies of disorders affecting the lymphatic vascular system have evolved rapidly in recent years. Although x-ray lymphangiography had been all but replaced by the advent of cross-sectional imaging and the scientific focus shifted to lymph node imaging (eg, for detection of metastatic disease), interest in lymph vessel imaging was rekindled by the introduction of lymphatic interventional treatments in the late 1990s. Although x-ray lymphangiography is still the mainstay imaging technique to guide interventional procedures, several other, often less invasive, techniques have been developed more recently to evaluate the lymphatic vascular system and associated pathologies. Especially the introduction of magnetic resonance, and even more recently computed tomography, lymphangiography with water-soluble iodinated contrast agent has furthered our understanding of complex pathophysiological backgrounds of lymphatic diseases. This has led to an improvement of treatment approaches, especially of nontraumatic disorders caused by lymphatic flow abnormalities including plastic bronchitis, protein-losing enteropathy, and nontraumatic chylolymphatic leakages. The therapeutic armamentarium has also constantly grown and diversified in recent years with the introduction of more complex catheter-based and interstitial embolization techniques, lymph vessel stenting, lymphovenous anastomoses, as well as (targeted) medical treatment options. The aim of this article is to review the relevant spectrum of lymphatic disorders with currently available radiological imaging and interventional techniques, as well as the application of these methods in specific, individual clinical situations.

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Lymphatic Interventions in the Cancer Patient

et al. 2022

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Povidone-iodine sclerotherapy of primary symptomatic lymphocele after kidney transplantation

Cited by 7 publications

References 18 publications

A comparison of lymphatic embolization and sclerotherapy in the management of iatrogenic abdominopelvic lymphoceles following oncological surgery

A comparison of lymphatic embolization and sclerotherapy in the management of iatrogenic abdominopelvic lymphoceles following oncological surgery

Back to the Future II—A Comprehensive Update on the Rapidly Evolving Field of Lymphatic Imaging and Interventions

Lymphatic Interventions in the Cancer Patient

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