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

Figures & data

Table 1 Patients’ Demographics and Clinical Characteristics

Patient No.	Cancer Type	Age (Year)	Lymph Node Dissection Range	Upper Border of Dissection	Positive/ Total Lymph Nodes	Chylous Test	Pre-PA-MSHA Treatment	Leakage Peak per Day	Drainage Time (Day)
1	CC	43	PLN	Common iliac vessels	0/61	_	FFD+DN+PN	980	15
2	OC	47	PLN+LPAN	Inferior mesenteric artery	0/67	+	FFD+DN+PN	400	13
3	EC	45	PLN+LPAN	Inferior mesenteric artery	0/42	+	FFD+DN	400	15
4	OC	35	PLN	Common iliac vessels	0/21	+	FFD+DN	300	8
5	EC	49	PLN+LPAN+UPAN	Renal vessels	7/27	+	FFD+DN+PN	380	18
6	OC	48	LPAN+UPAN	Renal vessels	17/28	+	FFD+DN	200	4
7	CC	47	PLN	Common iliac vessels	0/41	+	FFD	MVF	6*
8	CC	44	PLN	Common iliac vessels	0/67	+	FFD	MVF	6*
9	CC	65	PLN	Common iliac vessels	0/31	+	FFD	MVF	5*
10	CC	51	PLN	Common iliac vessels	0/54	+	FFD	MVF	4*

Note: *Refer to the indwelling time of drainage during the previous hospital stay.

Abbreviations: PLN, pelvic lymphadenectomy; LPAN, lower para-aortic lymph node dissection; UPAN, upper para-aortic lymph node dissection; PN, parenteral nutrition; FFD, fat-free diet; DN, drainage; MVF, massive vaginal fistula.

Table 2 PA-MSHA Treatment Outcomes

Patient No.	Leakage Output, mL			Side Effects
	Pre-PA-MSHA	Post-PA-MSMA
	Peak 24h	24h	48h	Fever	Pain
1	980	200	DR	38.1°C	+
2	400	0	DR	_	+
3	400	0	DR	_	+
4	300	2	DR	_	+
5	380	30	DR	_	++
6	200	30	DR	_	_
7	MVF	Vaginal spotting	DR	_	_
8	MVF	Vaginal spotting	DR	_	_
9	MVF	Vaginal spotting	DR	_	_
10	MVF	Vaginal spotting	DR	_	+

Abbreviations: DR, drain removed; PA-MSMA, Pseudomonas aeruginosa injection; +, mild; ++, severe; MVF, massive vaginal fistula.