Cohan R H, Saeed M, Sussman S K, Perlmutt L M, Schwab S J, Bowie J D, Dunnick N R
Department of Radiology, Duke University Medical Center, Durham, North Carolina 27710.
Invest Radiol. 1987 Nov;22(11):864-7. doi: 10.1097/00004424-198711000-00004.
Seventeen renal transplant patients with pelvic lymphatic fluid collections were treated with percutaneous drainage. Eleven of 16 patients with lymphoceles (69%) were successfully managed without surgery, although seven of these patients required repeat catheter insertions, and three patients developed local infections. The patient with an ovarian cystadenoma was treated with surgery. The mean duration of catheter insertion was ten days for initial drainage and 16 days for repeat drainage. Elevated serum creatinines decreased in 14 of the patients with lymphoceles (88%), including all five patients without pelvocaliectasis, but never returned to baseline in six instances. This observation may reflect the inadequate therapy of frequently encountered concurrent renal parenchymal abnormalities (rejection, cyclosporine toxicity, acute tubular necrosis). While percutaneous management of lymphoceles is technically easy and usually ultimately effective, the interventional radiologist should be prepared for long duration of catheter insertions, repeat interventions, and variable clinical courses. Differentiation of lymphoceles from other fluid collections, such as cystic ovarian neoplasms, may be difficult.
17例盆腔淋巴管积液的肾移植患者接受了经皮引流治疗。16例淋巴囊肿患者中有11例（69%）未经手术成功治疗，尽管其中7例患者需要再次插入导管，3例患者发生局部感染。卵巢囊腺瘤患者接受了手术治疗。初次引流时导管插入的平均持续时间为10天，再次引流时为16天。14例淋巴囊肿患者（88%）的血清肌酐升高有所下降，包括所有5例无肾盂扩张的患者，但有6例患者的血清肌酐从未恢复到基线水平。这一观察结果可能反映了对常见的并发肾实质异常（排斥反应、环孢素毒性、急性肾小管坏死）治疗不足。虽然经皮处理淋巴囊肿在技术上很容易，而且通常最终有效，但介入放射科医生应做好导管插入时间长、需要重复干预以及临床病程多变的准备。区分淋巴囊肿与其他液体积聚，如卵巢囊性肿瘤，可能会很困难。
