Hazır Berk, Haberal Hakan Bahadır, Akıncı Devrim, Akdoğan Bülent
Department of Urology, Hacettepe University School of Medicine, Ankara, Turkey.
Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey.
Int J Surg Case Rep. 2018;44:181-184. doi: 10.1016/j.ijscr.2018.02.036. Epub 2018 Mar 6.
A pelvic lymphocele is a collection of lymphatic fluid that develops after extensive lymphadenectomies in surgeries such as urological malignancies or renal transplantation. Pelvic lymphoceles may cause complications such as fever, abdominal pain, leg swelling, genital swelling and flank pain. This report summarizes the management of a pelvic lymphocele after open radical retropubic prostatectomy with bilateral lymphadenectomy.
Herein, we present a case in which a pelvic lymphocele developed seven months post-radical open retropubic prostatectomy and through this patient we discussed the lymphocele following radical prostatectomy. The pelvic lymphocele occurred along the sciatic nerve from the sciatica foramen to the intergluteal muscles. The patient was treated with three drainage catheters. This localization is an atypical and unusual for lymphocele after radical retropubic prostatectomy.
Lymphocele formation that leads to major complications after radical prostatectomy is rare. Lymphocele formation is most commonly seen in the early postoperative period, but it should be considered in patients with fever, abdominal pain or leg swelling during the late postoperative period. Lymphocele formation was the most common cause of hospital readmission after radical prostatectomy.
Lymphocele formation can be seen in atypical regions and can lead to unexpected complications after radical prostatectomy. Therefore, it should be brought to mind when complaints such as fever and lower extremity swelling occurred in patients underwent extensive lymph node dissection. Surgical treatment options are available, but percutaneous interventions can also be used.
盆腔淋巴囊肿是在诸如泌尿外科恶性肿瘤手术或肾移植等广泛淋巴结清扫术后形成的淋巴液聚集。盆腔淋巴囊肿可能会引起发热、腹痛、腿部肿胀、生殖器肿胀和胁腹疼痛等并发症。本报告总结了开放性耻骨后根治性前列腺切除术联合双侧淋巴结清扫术后盆腔淋巴囊肿的处理情况。
在此,我们报告一例在开放性耻骨后根治性前列腺切除术后七个月出现盆腔淋巴囊肿的病例,并通过该患者讨论了根治性前列腺切除术后的淋巴囊肿情况。盆腔淋巴囊肿沿着坐骨神经从坐骨孔延伸至臀间肌。该患者接受了三根引流导管治疗。这种定位在耻骨后根治性前列腺切除术后的淋巴囊肿中是非典型且不常见的。
根治性前列腺切除术后导致严重并发症的淋巴囊肿形成较为罕见。淋巴囊肿形成最常见于术后早期,但对于术后晚期出现发热、腹痛或腿部肿胀的患者也应予以考虑。淋巴囊肿形成是根治性前列腺切除术后再次入院的最常见原因。
淋巴囊肿形成可见于非典型区域,且在根治性前列腺切除术后可导致意想不到的并发症。因此,对于接受广泛淋巴结清扫的患者出现发热和下肢肿胀等症状时应予以考虑。虽然有手术治疗选择,但也可采用经皮干预措施。