Mikami Hiroshi, Ito Keiichi, Yoshii Hidehiko, Kosaka Takeo, Miyajima Akira, Kaji Tatsumi, Asano Tomohiko, Hayakawa Masamichi
Department of Urology, National Defense Medical College.
Hinyokika Kiyo. 2008 Jan;54(1):23-7.
A 68-year-old male visited our division with an elevation of PSA level. He underwent a needle biopsy of the prostate, and the histopathological diagnosis was poorly differentiated adenocarcinoma (Gleason score 4+3). The cancer was clinically diagnosed as T2aN0M0, and he underwent extraperitoneal laparoscopic radical prostatectomy and bilateral pelvic lymphadenectomy. Cystography 14 days after the operation still showed leakage at the vesico-urethral anastomosis and a dumbbell shaped bladder. A few days later, prominence of lower abdomen and a slight swelling of right leg presented with a high fever. Computed tomography revealed a giant lymphocele in the retroperitoneal space. We percutaneously punctured the lymphocele by using ultrasonography, inserted a pigtail catheter, and drained 1,000 ml of lymphatic fluid. After the puncture, sclerotherapy with minocycline was performed four times. Twenty days after the puncture, the lymphocele cavity was found to have shrunken and the pigtail catheter was removed. The lymphocele was diminished and did not recur thereafter.
一名68岁男性因前列腺特异性抗原（PSA）水平升高前来我科就诊。他接受了前列腺穿刺活检，组织病理学诊断为低分化腺癌（ Gleason评分4 + 3）。该癌症临床诊断为T2aN0M0，他接受了腹膜外腹腔镜前列腺癌根治术和双侧盆腔淋巴结清扫术。术后14天的膀胱造影仍显示膀胱尿道吻合处有渗漏，膀胱呈哑铃形。几天后，患者出现下腹部隆起和右腿轻度肿胀，并伴有高热。计算机断层扫描显示腹膜后间隙有巨大淋巴囊肿。我们使用超声对淋巴囊肿进行经皮穿刺，插入一根猪尾导管，引流了1000毫升淋巴液。穿刺后，用米诺环素进行了四次硬化治疗。穿刺20天后，发现淋巴囊肿腔已缩小，猪尾导管被拔除。淋巴囊肿缩小，此后未复发。
