MINIMALLY INVASIVE TREATMENT OF ABDOMINAL LYMPHOCELE: A REVIEW OF CONTEMPORARY OPTIONS AND HOW TO APPROACH THEM

Abstract

Lymphoceles are lymphatic fluid collections
resulting from lymphatic vessel disruption
after surgery or trauma. They are most often
described following retroperitoneal surgeries
such as cystectomies, prostatectomies, renal
transplants, and gynecologic surgeries. Most
lymphoceles are asymptomatic and resolve
spontaneously without treatment. If persistent,
they can become infected or exert mass effect on
adjacent structures causing pain, urinary, or
lower limb edema particularly for lymphoceles in
the pelvis Symptomatic lymphoceles should be
treated to relieve symptoms and prevent functional
compromise of vital adjacent structures.
Although surgery has been traditionally
accepted as the gold standard treatment,
advances in imaging and interventional
technology allow for less invasive, percutaneous
treatment. Available minimally invasive
treatment options include percutaneous
aspiration, catheter drainage, sclerotherapy,
and lymphangiography with lymphatic
embolization. A review of these treatment
options and a suggested algorithm for
managing lymphoceles is presented.