Juntermanns B, Cyrek A E, Bernheim J, Hoffmann J N
Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Deutschland.
Contilia Herz- und Gefäßzentrum, Klinik für Gefäßchirurgie und Phlebologie, Elisabeth-Krankenhaus Essen, Essen, Deutschland.
Chirurg. 2017 Jul;88(7):582-586. doi: 10.1007/s00104-017-0378-3.
The postoperative occurrence of lymph fistulas in the groin is a complication that should be taken seriously. These fistulas cause an increase in morbidity and can support local and ascending infections. The treatment of this complication ranges from conservative procedures, such as compression dressings and bed rest to operative treatment with detection of the fistulas and ligation, negative pressure wound therapy (NPWT) or even muscle flaps. This review provides an overview of current therapeutic modalities.
On the basis of a current literature search via PubMed, we identified possible treatment options, which are described in this article.
The conservative treatment options presented still have an importance in treating groin fistulas. A selection of safe and effective interventional and operative treatments is presented.
If there are indications for an interventional or operative treatment a variety of safe and effective therapies are available, which can significantly reduce the length of hospital stay. The option of treatment using a muscle flap is of value as a last resort in the treatment of infected vascular prosthesis in the groin of Szilagyi type III and should be used when necessary.
腹股沟区术后发生淋巴瘘是一种应予以重视的并发症。这些瘘会导致发病率增加,并可能引发局部及上行性感染。该并发症的治疗方法多样,从保守治疗,如加压包扎和卧床休息,到手术治疗,包括瘘管探查与结扎、负压伤口治疗(NPWT)甚至肌皮瓣转移。本综述概述了当前的治疗方式。
基于通过PubMed进行的当前文献检索,我们确定了本文所述的可能治疗方案。
所介绍的保守治疗方案在腹股沟瘘的治疗中仍具有重要意义。同时还介绍了一系列安全有效的介入及手术治疗方法。
如果有介入或手术治疗的指征,有多种安全有效的治疗方法可供选择,这些方法可显著缩短住院时间。肌皮瓣转移治疗作为治疗Szilagyi III型腹股沟感染性血管假体的最后手段具有重要价值,必要时应予以采用。