[Prevention and treatment of lymphatic fistulas after arterial reconstruction in the lower extremity].

Lymphatic fistula is a complication of 2% of surgical vascular reconstruction in the groin especially in the critically ischaemic limb. We investigated the incidence of lymphatic fistula, its prevention and treatment in patients at the Department of Surgery of the Ruzinov Hospital in Bratislava during the period of 5 years. 7 patients out of 162 (4.44%) had lymphatic fistula in the groin. The patients underwent 172 operation involving 209 groin incisions. Lymphatic fistula developed in 7 groin incisions--3.34%. Operations included 36 aortobifemoral bypass procedures, 2 unilateral bypass procedures, 76 femoropopliteal bypass procedures or profundoplastic surgeries, 48 embolectomies. The diagnosis was based upon the clinical findings of the characteristic persistent watery discharge in the groin after vascular operation. Conservative treatment was successful in all patients, the average duration of lymphatic fistula was 27.2 days. Lymphatic fistula may be complicated in 25% of patients by wound infection but it shouldn't be regarded as the first degree of infection in vascular surgery. (Ref.12)