Division of General Surgery, Department of Surgery, Medical University of South Carolina, Charleston, South Carolina.
Wounds. 2021 Jul;33(7):E42-E45.
Lymphocele is a relatively common complication following lymphadenectomy of the inguinal lymph nodes; however, it is less common after open inguinal hernia repair. Postoperative lymphocele is usually caused by unrecognized injury to lymphatic vessels during surgical dissection and commonly requires reoperation to ligate the leaking lymphatics. Angiomyomatous hamaromas are rare lymphatic formations of unknown cause that can be treated with aspiration, sclerotherapy, and drain placement, but surgical intervention is often required. This finding is associated with replacement of parenchymal lymph tissue with vascular and smooth muscle cells.
The authors report the case of a 59-year-old African American male who underwent open inguinal hernia repair and was found to have incidentally an angiomyomatous hamartoma, which was excised but complicated with a postoperative lymphocele. The patient was successfully treated with the aid of negative pressure wound therapy.
Negative pressure wound therapy has rarely been used to treat postoperative lymphocele. To the authors' knowledge, this case is the first to document use of negative pressure wound therapy for lymphocele following angiomyomatous hamartoma excision.
淋巴囊肿是腹股沟淋巴结清扫术后的一种相对常见的并发症;然而,在开放式腹股沟疝修补术后则不太常见。术后淋巴囊肿通常是由于手术解剖过程中未识别到淋巴管损伤引起的,通常需要再次手术结扎渗漏的淋巴管。血管平滑肌脂肪瘤是一种罕见的淋巴组织形成,病因不明,可以通过抽吸、硬化治疗和引流来治疗,但通常需要手术干预。这种发现与实质淋巴组织被血管和平滑肌细胞取代有关。
作者报告了一例 59 岁的非裔美国男性,他接受了开放式腹股沟疝修补术,偶然发现了血管平滑肌脂肪瘤,该肿瘤被切除,但术后并发淋巴囊肿。患者在负压伤口治疗的帮助下成功治疗。
负压伤口治疗很少用于治疗术后淋巴囊肿。据作者所知,这是首例记录使用负压伤口治疗切除血管平滑肌脂肪瘤后淋巴囊肿的病例。