Topical Application of Pseudomonas aeruginosa-Mannose Sensitive Hemagglutinin (PA-MSHA) for Refractory Lymphatic Leakage Following Lymphadenectomy in Patients with Gynecological Malignancies

Abstract

Purpose

To observe the feasibility and efficacy of Pseudomonas aeruginosa-mannose sensitive hemagglutinin (PA-MSHA) in refractory lymphatic leakage following lymphadenectomy among patients with gynecological cancers.

Patients and Methods

Ten cases with post-operative massive lymphatic leakage were collected, in which patients failed to respond to conservative treatment. Topical PA-MSHA injection of a single dose (2mL) was performed through drainage tube or transvaginal catheter into pelvic or peritoneal cavity. Drainage volumes and side effects were recorded.

Results

The incidence of refractory lymphatic leakage following pelvic and para-aortic lymphadenectomy was 2.44% (10/409). All ten patients (100%) had quick recovery and were discharged within 72 hours. Among them, one patient (10%) experienced fever and six patients (60%) experienced abdominal pain, one of which was moderate and relieved by routine analgesic treatment. During 11 (6–38) months of follow-up time, no long-term side effect was observed.

Conclusion

Topical injection of PA-MSHA of a single dose appears a feasible and effective treatment for refractory post-operative lymphatic leakage.

Keywords:

• Pseudomonas aeruginosa-mannose sensitive hemagglutinin (PA-MSHA) injection
• pelvic and para-aortic lymphadenectomy
• lymphatic leakage
• chylous leakage

Acknowledgment

We thank Prof. Xin-Liang Su, in the Department of Endocrine and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, for his introduction of this medicine for such patients. This work was supported by grants from the National Natural Science Foundation of China (NSFC No. C81572562).

Author Contributions

Rong Zhou and Jie Xu contributed equally to this paper. All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.