Retroperitoneal lymphocele after anterior spinal surgery
Alpesh A Patel1, William R Spiker, Michael D Daubs
1Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT 84108, USA. alpesh.patel@hsc.utah.edu
Spine
|August 19, 2008
Summary
Retroperitoneal lymphocele is a rare complication following anterior lumbar surgery. Laparoscopic marsupialization offers an effective treatment option for this condition, leading to symptom resolution and improved patient outcomes.
Area of Science:
- Spine surgery
- Surgical complications
- Retroperitoneal lymphocele
Background:
- Anterior lumbar surgery can lead to various complications, including vascular, ureteral, and neurologic injuries.
- Retroperitoneal lymphocele is an uncommon complication, with limited literature on its diagnosis and management.
- This study addresses the rarity of retroperitoneal lymphocele after anterior lumbar interbody fusion.
Observation:
- A 76-year-old woman developed a retroperitoneal lymphocele six weeks after undergoing extensive lumbar fusion surgery.
- Symptoms included severe abdominal pain, nausea, and emesis, indicative of a significant postoperative complication.
- The lymphocele was confirmed via aspiration and differentiated from other potential diagnoses like abscess or urinoma.
Findings:
- Laparoscopic marsupialization was successfully employed to treat the retroperitoneal lymphocele.
- The patient experienced no recurrence of the lymphocele and reported significant improvement in back and leg pain.
- Radiographic findings remained stable at 12 months post-procedure, indicating successful surgical management.
Implications:
- Retroperitoneal lymphocele, though rare, should be considered in the differential diagnosis of postoperative abdominal symptoms after anterior lumbar surgery.
- Accurate diagnosis can be aided by analyzing serum and cyst fluid.
- Surgical intervention, such as marsupialization, appears to be a reliable treatment for symptomatic retroperitoneal lymphoceles.