Fung Y M, Wong W S
Department of Obstetrics & Gynaecology, Faculty of Medicine, Chinese University of Hong Kong, Shatin, New Territories.
Gynecol Oncol. 1992 Mar;44(3):288-90. doi: 10.1016/0090-8258(92)90060-v.
Lymphocyst is a well-known complication after Wertheim's operation with an incidence varying from 2 to 20%. The majority are asymptomatic. However, when complications occur, the symptoms depend on the location and the pressure effects created. Most of the lymphocysts occur within 1 year after surgery and need to be differentiated from a hematoma or urinoma. At present, there is no standard management of early lymphocysts. Conservative management, ultrasound-guided needle aspiration, or percutaneous insertion of an indwelling catheter have been successfully employed. Intraperitoneal marsupilization with or without omental falp is also highly effective. When pelvic lymphocysts occur later than normal, the diagnostic dilemma is to differentiate benign collections from those involving recurrent tumor. Fine-needle biopsy of the cyst wall under ultrasound guidance is more effective in identifying recurrence than cytological evaluation of the fluid. Nonetheless, if such facility is not readily available, surgical drainage and excision of the cyst wall should be considered to ensure early diagnosis of recurrence.
淋巴囊肿是韦特海姆手术后一种众所周知的并发症，发生率在2%至20%之间。大多数患者无症状。然而，当出现并发症时，症状取决于囊肿的位置及其造成的压迫效应。大多数淋巴囊肿在术后1年内出现，需要与血肿或尿囊肿相鉴别。目前，对于早期淋巴囊肿尚无标准的治疗方法。保守治疗、超声引导下针吸术或经皮留置导管已成功应用。有或无网膜瓣的腹膜开窗术也非常有效。当盆腔淋巴囊肿出现时间晚于正常情况时，诊断上的难题是要区分良性积液与复发性肿瘤。超声引导下对囊肿壁进行细针活检在识别复发方面比囊液的细胞学评估更有效。尽管如此，如果没有这种便利条件，应考虑手术引流并切除囊肿壁以确保早期诊断复发。
