Hackert Thilo, Werner Jens, Loos Martin, Büchler Markus W, Weitz Jürgen
Department of Surgery, Im Neuenheimer Feld 110, Heidelberg 69120, Germany.
Langenbecks Arch Surg. 2006 Aug;391(4):435-8. doi: 10.1007/s00423-006-0050-8. Epub 2006 May 9.
Lymphatic fistulas are commonly known complications after lymph node or soft tissue resection, requiring long and sometimes difficult therapy. Doxycycline is an antibiotic agent, which was used in the treatment of pneumothoraces and pleural effusions. The aim of the study was to evaluate the effect of local doxycycline instillation on postoperative lymphatic effusions.
Five patients with postoperative lymphatic fistulas of different locations (inguinal, gluteal, and thoracic) were included. Patients received local doxycycline instillation after a postoperative observation period of 19-27 days without spontaneous closure of the fistulas.
Postoperative lymphatic fistulas closed after a single injection of doxycycline in four out of five patients within 2 days, in one patient, injection had to be repeated to achieve closure of the fistula. Drain removal was possible within 4 days after instillation in all patients; no complications occurred.
Doxycycline can be used for treatment of persistent postoperative lymphatic fistulas in different locations. In further studies, this therapeutic concept should be evaluated with larger numbers of patients with regard to the ideal point of time, frequency, and mode of application.
淋巴管瘘是淋巴结或软组织切除术后常见的并发症，治疗过程漫长，有时还颇具难度。强力霉素是一种抗生素，曾用于治疗气胸和胸腔积液。本研究旨在评估局部注入强力霉素对术后淋巴积液的疗效。
纳入5例不同部位（腹股沟、臀部和胸部）术后淋巴管瘘患者。在术后观察19 - 27天且瘘口未自行闭合后，患者接受局部强力霉素注入治疗。
5例患者中有4例在单次注射强力霉素后2天内瘘口闭合，1例患者需重复注射才能使瘘口闭合。所有患者在注入后4天内均可拔除引流管；未发生并发症。
强力霉素可用于治疗不同部位的持续性术后淋巴管瘘。在进一步研究中，应就理想的治疗时间点、频率和应用方式，对更多患者评估这一治疗理念。
