Sclerotherapy in the management of postoperative lymphocele.

PURPOSE

To describe a single-center experience with sclerotherapy of postoperative lymphocele and to determine the risk factors for failure of treatment.

MATERIALS AND METHODS

From 1999 to 2007, 43 patients with postsurgical lymphocele were treated with sclerotherapy with a combination of povidone iodine, alcohol, and doxycycline. The treatments were repeated at weekly intervals. The initial drainage volume of the lymphocele, the location of the lymphocele, the number of treatments, and the outcomes were retrospectively collected.

RESULTS

In 38 patients, the lymphocele was drained percutaneously, and in five patients, the treatment was initiated through an existing surgically placed drainage tube. Sclerotherapy was successful in 33 patients (77%). Complications that resulted in termination of the treatment were seen in five patients (12%): testicular pain, cellulitis, posttreatment increase in creatinine, acute renal tubular necrosis, and abdominal infection. In one of these patients the lymphocele resolved after resolution of the infection. The average number of treatments was four (range, 1-14). There was no difference in success rate between superficial intraabdominal and soft-tissue lymphoceles. There was a significant difference (P < .05) in the fluid volume at initial drainage between the failure group (1,708 mL +/- 1,521) and the success group (206 mL +/- 213). This assumes an attempt was made to drain the collection completely at the initial procedure.

CONCLUSIONS

Sclerotherapy of postoperative lymphoceles is an effective treatment. Success of sclerotherapy is directly related to the size of the lymphocele cavity.