Ultrasonic evaluation of lymphocele formation after staging lymphadenectomy for prostatic carcinoma.

Spring, D B; Schroeder, David E.; Babu, S; Agee, Robert E.; Gooding, Gretchen A. W.

doi:10.1148/radiology.141.2.7291577

Cited by 56 publications

(26 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Some authors report a low rate of LC formation after RPE because pelvic LAE is often not routinely performed [19], or only clinically apparent LCs or those requiring intervention are reported [19,31,32]. A much higher LC rate ranging from 27 to 61% is found where LCs are specifically tested for using imaging techniques [33][34][35], which agrees with the results of our study. Heinzer et al [36] reported benefits of screening for pelvic LCs after RPE in a cohort study, as rapid treatment of LCs resulted in a significant reduction in thromboembolic events (6.2% vs. 2.1%, P < 0.049).…”

Section: Discussionsupporting

confidence: 90%

Incidence, risk profile and morphological pattern of venous thromboembolism after prostate cancer surgery

Beyer

Wessela

Hakenberg

et al. 2009

Journal of Thrombosis and Haemostasis

View full text Add to dashboard Cite

To cite this article: Beyer J, Wessela S, Hakenberg OW, Kuhlisch E, Halbritter K, Froehner M, Wirth MP, Schellong SM. Incidence, risk profile and morphological pattern of venous thromboembolism after prostate cancer surgery. J Thromb Haemost 2009; 7: 597-604.Summary. Background: Venous thromboembolism (VTE) is the most common non-surgical complication after major pelvic surgery. Little is known about the risk factors or the time of development of postoperative venous thrombosis. Methods: A cohort of 523 consecutive patients undergoing radical prostatectomy with lymphadenectomy was prospectively assessed by complete compression ultrasound at days )1, +8 and +21. Results: Complete data were available in 415 patients, while four patients had VTE before surgery and were excluded from the analysis. In the remaining 411 patients, 71 VTE events were found in 69 patients (16.8%). Most were limited to calf muscle veins (56.5%), followed by deep calf vein thrombosis (23.2%), proximal deep vein thrombosis (DVT, 14.5%) and pulmonary embolism (PE, 5.8%). Of the 14 patients with proximal DVT/PE, 11 patients (78.6%) developed VTE between days 8 and 21. Risk factors for VTE were a personal history of VTE (OR 3.0), pelvic lymphoceles (LCs) impairing venous flow (OR 2.8) and necessity of more than two units of red blood cells (OR 2.6). Conclusion: Venous thromboembolism is common after radical prostatectomy. A significant proportion develops after day 8, suggesting that prolonged heparin prophylaxis should be considered. Since LCs with venous flow reduction result in higher rates of VTE, hemodynamically relevant lymphoceles should be surgically treated.

show abstract

Section: Discussionsupporting

confidence: 90%

Incidence, risk profile and morphological pattern of venous thromboembolism after prostate cancer surgery

Beyer

Wessela

Hakenberg

et al. 2009

Journal of Thrombosis and Haemostasis

View full text Add to dashboard Cite

show abstract

“…However, our rate was lower than that originally obtained when any sonographically or radiographically detected lymphocele was considered (range: 27-61%) (8,9). Despite an incidence of 21%, in the current study the overall rate of clinically significant SPL after PLA and RRP was 12%.…”

Section: Commentscontrasting

confidence: 76%

Uni- vs. multiloculated pelvic lymphoceles: differences in the treatment of symptomatic pelvic lymphoceles after open radical retropubic prostatectomy

et al. 2009

View full text Add to dashboard Cite

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.

show abstract

“…A careful review of the literature revealed only 3 other reported cases of delayed infected lymphocele after surgery [4][5][6] . Two of the reported cases had an infected lymphocele more than 1 year Fig.…”

Section: Discussionmentioning

confidence: 99%

“…CT of patient 1 shows almost complete resolution of lymphocele (arrow) after 4 weeks. after surgery [5,6] . In all cases, the patients presented with chills and fever of unknown etiology.…”

Section: Discussionmentioning

confidence: 99%

Delayed Infection of a Pelvic Lymphocele following Robotic Radical Prostatectomy and Pelvic Lymphadenectomy: Two Cases

Tremp

Sulser

Seifert³

2009

Urol Int

View full text Add to dashboard Cite

Pelvic lymphocele is an infrequent complication of pelvic surgery, usually presenting shortly after surgery. We report 2 cases with a delayed infected pelvic lymphocele presenting after transperitoneal pelvic lymphadenectomy and robotic radical prostatectomy for adenocarcinoma of the prostate. These cases illustrate that late infection of pelvic lymphoceles may occur following radical prostatectomy and pelvic lymphadenectomy. The practicing urologist should be aware of this possibility and look for an infected lymphocele in postoperative pelvic lymphadenectomy patients presenting with fever and leukocytosis of uncertain etiology, regardless of the time elapsed since surgery. To date, there is a paucity of data in the literature on robotic- assisted laparoscopic resection of a lymphocele after radical prostatectomy. The minimally invasive technique can be considered as a possible alternative to lymphocele percutaneous drainage. It is effective, results in minimal patient morbidity and allows for rapid recovery.

show abstract

Ultrasonic evaluation of lymphocele formation after staging lymphadenectomy for prostatic carcinoma.

Cited by 56 publications

References 0 publications

Incidence, risk profile and morphological pattern of venous thromboembolism after prostate cancer surgery

Incidence, risk profile and morphological pattern of venous thromboembolism after prostate cancer surgery

Uni- vs. multiloculated pelvic lymphoceles: differences in the treatment of symptomatic pelvic lymphoceles after open radical retropubic prostatectomy

Delayed Infection of a Pelvic Lymphocele following Robotic Radical Prostatectomy and Pelvic Lymphadenectomy: Two Cases

Contact Info

Product

Resources

About