Nishibeppu Keiji, Arita Tomohiro, Nakanishi Masayoshi, Kuriu Yoshiaki, Murayama Yasutoshi, Shoda Katsutoshi, Kosuga Toshiyuki, Konishi Hirotaka, Morimura Ryo, Komatsu Shuhei, Shiozaki Atsushi, Ikoma Hisashi, Ichikawa Daisuke, Fujiwara Hitoshi, Okamoto Kazuma, Otsuji Eigo
Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachihirokoji, Kamigyo-ku, Kyoto, Japan.
Radiol Case Rep. 2017 Sep 28;12(4):760-763. doi: 10.1016/j.radcr.2017.08.014. eCollection 2017 Dec.
A lymphocele is one of the complications of systematic pelvic or para-aortic lymphadenectomy. Although most patients are entirely asymptomatic, our patient exhibited an obstructive ileus at the jejunum compressed by a lymphocele. We report here a case of a subsequent para-aortic lymphocele treated with autologous peripheral blood injection. A 68-year-old woman with sigmoid colon cancer (T3N2bM1a) underwent laparoscopic sigmoidectomy. After 4 courses of chemotherapy (CapeOX + Bmab), para-aortic lymphadenectomy was additionally performed. One month later, an obstructive ileus occurred suddenly due to a lymphocele. A drainage catheter was placed into the lymphocele and a total of 35 mL of autologous peripheral blood was injected in 4 divided doses through the catheter. The volume of the lymphocele gradually reduced and the ileus improved after blood injection. This is the first report of a successful case of a subsequent para-aortic lymphocele treated with autologous peripheral blood injection without any complications.
淋巴管瘤是系统性盆腔或主动脉旁淋巴结清扫术的并发症之一。尽管大多数患者完全没有症状,但我们的患者出现了由淋巴管瘤压迫空肠导致的肠梗阻。我们在此报告一例经自体外周血注射治疗的主动脉旁淋巴管瘤病例。一名68岁乙状结肠癌(T3N2bM1a)女性接受了腹腔镜乙状结肠切除术。在进行4个疗程的化疗(CapeOX + Bmab)后,又进行了主动脉旁淋巴结清扫术。1个月后,因淋巴管瘤突然发生肠梗阻。将引流导管置入淋巴管瘤,通过导管分4次共注入35 mL自体外周血。注入血液后,淋巴管瘤体积逐渐缩小,肠梗阻症状改善。这是首例经自体外周血注射成功治疗主动脉旁淋巴管瘤且无任何并发症的报告。