Tremp Mathias, Sulser Tullio, Seifert Hans-Helge
Department of Urology, University Hospital, Zurich, Switzerland.
Urol Int. 2009;83(4):479-81. doi: 10.1159/000251192. Epub 2009 Dec 8.
Pelvic lymphocele is an infrequent complication of pelvic surgery, usually presenting shortly after surgery. We report 2 cases with a delayed infected pelvic lymphocele presenting after transperitoneal pelvic lymphadenectomy and robotic radical prostatectomy for adenocarcinoma of the prostate. These cases illustrate that late infection of pelvic lymphoceles may occur following radical prostatectomy and pelvic lymphadenectomy. The practicing urologist should be aware of this possibility and look for an infected lymphocele in postoperative pelvic lymphadenectomy patients presenting with fever and leukocytosis of uncertain etiology, regardless of the time elapsed since surgery. To date, there is a paucity of data in the literature on robotic- assisted laparoscopic resection of a lymphocele after radical prostatectomy. The minimally invasive technique can be considered as a possible alternative to lymphocele percutaneous drainage. It is effective, results in minimal patient morbidity and allows for rapid recovery.
盆腔淋巴囊肿是盆腔手术中不常见的并发症,通常在术后不久出现。我们报告2例经腹盆腔淋巴结清扫术和机器人辅助根治性前列腺切除术后出现延迟感染性盆腔淋巴囊肿的病例,患者均患有前列腺腺癌。这些病例表明,根治性前列腺切除术和盆腔淋巴结清扫术后可能发生盆腔淋巴囊肿的迟发性感染。泌尿外科医生应意识到这种可能性,对于术后出现发热和病因不明的白细胞增多症的盆腔淋巴结清扫术患者,无论手术过去多长时间,都应排查是否存在感染性淋巴囊肿。迄今为止,关于机器人辅助腹腔镜下根治性前列腺切除术后淋巴囊肿切除术的文献资料匮乏。微创技术可被视为淋巴囊肿经皮引流的一种可能替代方法。它有效,对患者的发病率最小,并能使患者快速康复。