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Abstract
Purpose:
This article described intranodal lymphangiography and embolization of patients with lymphatic leak post-operation of the groin region for various aetiologies (lymph node resection, femoral artery exposure).
Materials and Methods:
A retrospective analysis from 2018 to 2020 was performed and twelve consecutive patients underwent intranodal lymphangiography and intranodal lymphatic embolization to treat lymphorrhea or lymphocele post-operation of the groin. All the lymph nodes around the wound were punctured for lymphangiography. If the extravasation was found from the lymph node, the glue N-butyl cyanoacrylate (NBCA) diluted with lipiodol (ratio of 1:4) was injected to occlude the lymphatic vessel laceration.
Results:
All the lymph nodes around the wound were punctured with the median number of two lymph nodes for each patient (range from one to four lymph nodes); there were three patients with two leakage points. Intranodal lymphatic embolization was performed by glue NBCA diluted 1:4 with lipiodol. Additional treatment includes sclerotherapy (n=5) and percutaneous muscular flap operation (n=1). Clinical successful was achieved in twelve patients (100%) with no major complications. One patient experienced lymphedema which was was treated by compression stockings and rehabilitation therapy.
Conclusion:
Intranodal lymphangiography and embolization are effective methods to treat iatrogenic lymphatic leak while all the lymph nodes around the wound should be punctured to avoid missing lesions from other lymphatic vessels.
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the local ethics committee of Hanoi medical university hospital.
Informed Consent
Patients’ informed consent included in this research was obtained from all individual participants in the study.
Consent for Publication
Consent for publication was obtained for every individual person’s data included in the study.
Funding
This study was not supported by any funding.
Disclosure
All authors declare that they have no conflicts of interest for this work.