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腹部淋巴囊肿的微创治疗:当代治疗方法及处理策略综述

Minimally invasive treatment of abdominal lymphocele: A review of contemporary options and how to approach them.

作者信息

Khorshidi F, Majdalany B S, Peters G, Tran A N, Shaikh J, Liddell R P, Perez Lozada J C, Kokabi N, Nezami N

机构信息

Department of Radiology, Tabriz University of Medical Sciences, Tabriz, Iran.

Division of Interventional Radiology and Image-Guided Medicine, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA.

出版信息

Lymphology. 2021;54(2):56-67.

Abstract

Lymphoceles are lymphatic fluid collections resulting from lymphatic vessel disruption after surgery or trauma. They are most often described following retroperitoneal surgeries such as cystectomies, prostatectomies, renal transplants, and gynecologic surgeries. Most lymphoceles are asymptomatic and resolve spontaneously without treatment. If persistent, they can become infected or exert mass effect on adjacent structures causing pain, urinary, or lower limb edema particularly for lymphoceles in the pelvis Symptomatic lymphoceles should be treated to relieve symptoms and prevent functional compromise of vital adjacent structures. Although surgery has been traditionally accepted as the gold standard treatment, advances in imaging and interventional technology allow for less invasive, percutaneous treatment. Available minimally invasive treatment options include percutaneous aspiration, catheter drainage, sclerotherapy, and lymphangiography with lymphatic embolization. A review of these treatment options and a suggested algorithm for managing lymphoceles is presented.

摘要

淋巴管囊肿是手术或创伤后淋巴管破裂导致的淋巴液聚集。它们最常出现在腹膜后手术之后,如膀胱切除术、前列腺切除术、肾移植手术和妇科手术。大多数淋巴管囊肿无症状,无需治疗即可自行消退。如果持续存在,它们可能会感染或对相邻结构产生占位效应,引起疼痛、泌尿系统问题或下肢水肿,骨盆部位的淋巴管囊肿尤其如此。有症状的淋巴管囊肿应进行治疗以缓解症状并防止重要相邻结构的功能受损。虽然传统上手术一直被视为金标准治疗方法,但成像和介入技术的进步使得侵入性较小的经皮治疗成为可能。现有的微创治疗选择包括经皮抽吸、导管引流、硬化治疗以及淋巴管造影和淋巴栓塞。本文介绍了这些治疗选择以及管理淋巴管囊肿的建议流程。

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