Janco Jo Marie Tran, Gloviczki Peter, Friese Jeremy L, Cliby William A
Divisions of Gynecologic Surgery, Vascular Surgery, and Vascular and Interventional Radiology, Mayo Clinic, Rochester, Minnesota.
Obstet Gynecol. 2015 Feb;125(2):434-437. doi: 10.1097/AOG.0000000000000550.
Ascites after lymphatic dissection, usually amenable to conservative management, may require surgery. We describe a technique in the context of treatment for gynecologic malignancy to localize and ligate lymphatic leaks.
The patient was a 37-year-old woman with recurrent ovarian carcinoma, who developed recurrent chylous and lymphatic ascites after secondary cytoreduction surgery including lymph node resection in multiple basins. Ascites were refractory despite paracenteses, dietary modification, and octreotide therapy. Sclerotherapy was unsuccessful. Surgical ligation of the lymphatic leak was accomplished with injection of isosulfan blue dye into groin nodes to assist with localization.
Select cases of persistent ascites after surgery for gynecologic malignancy will require surgery after conservative measures are attempted. Awareness of options for management is important for those caring for women with gynecologic cancer.
淋巴清扫术后出现的腹水通常可采用保守治疗，但可能需要手术治疗。我们描述一种在妇科恶性肿瘤治疗中定位并结扎淋巴漏的技术。
患者为一名37岁复发性卵巢癌女性，在包括多区域淋巴结切除的二次肿瘤细胞减灭术后出现复发性乳糜性和淋巴性腹水。尽管进行了腹腔穿刺、饮食调整和奥曲肽治疗，腹水仍难以控制。硬化治疗未成功。通过向腹股沟淋巴结注射异硫蓝染料以辅助定位，完成了淋巴漏的手术结扎。
妇科恶性肿瘤手术后出现持续性腹水的特定病例，在尝试保守治疗措施后将需要手术治疗。对于照顾妇科癌症女性患者的人员而言，了解管理方案很重要。
