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Retroperitoneal lymphocele after abdominal aortic surgery
H E Garrett1, J W Richardson, H S Howard
1Division of Peripheral Vascular Surgery, University of Tennessee, Memphis.
Journal of Vascular Surgery
|September 1, 1989
Summary
Persistent retroperitoneal lymphoceles after abdominal aortic surgery can be treated by reexploring the retroperitoneum and ligating injured lymphatics. Early prevention through careful surgical technique is key.
Area of Science:
- Vascular Surgery
- Surgical Complications
- Lymphatic Physiology
Background:
- Abdominal aortic surgery can lead to lymphatic injury, resulting in lymphocele formation.
- Lymphoceles present as retroperitoneal masses or groin collections.
- These collections can manifest years after the initial surgery.
Observation:
- Four cases of persistent retroperitoneal lymphoceles, diagnosed 2-8 years post-surgery, are presented.
- Previous treatments including groin reexploration and fluid aspirations were ineffective.
- Retroperitoneal reexploration identified and successfully ligated lymphatic injuries.
Findings:
- Literature review reveals 5 similar retroperitoneal lymphocele cases and 12 cases of chylous ascites post-abdominal aortic surgery.
- Diagnosis of persistent lymphocele is confirmed by aspiration.
- Surgical ligation of injured lymphatics in the retroperitoneum is effective in controlling drainage.
Implications:
- Avoiding or immediately repairing lymphatic injuries during surgery is crucial for prevention.
- Reexploration of the retroperitoneum is necessary for managing persistent lymphoceles.
- Effective management of lymphoceles can prevent complications such as graft infection.
