Intraperitoneal OK-432 infusion for postoperative lymphatic leakage in gynecologic tumors

Postoperative lymphatic leakage is a challenging complication following radical surgery for gynecologic malignancies. Effective medical treatment for controlling lymphatic leakage is still lacking. This study analyzed the clinical efficacy and safety of intraperitoneal OK-432 perfusion for managing postoperative lymphatic leakage.

We conducted a retrospective cohort study involving 9 patients who developed postoperative lymphatic leakage after pelvic lymph node dissection with or without para-aortic lymphadenectomy for gynecologic tumors. All patients received a single intraperitoneal perfusion of OK-432.

The mean age and BMI of the patients were 53.1 years old and 22.7. The primary site was endometrium, ovary, cervix and fallopian tube in 5, 1, 2, and 1 patient, respectively. Most patients had adenocarcinoma (6/9). The FIGO stages were I, II, and III in 3 patients each. The mean number of resected lymph nodes was 24.6 and 7 patients underwent para-aortic lymphadenectomy. Seven patients underwent robotic/laparoscopic surgery while open surgery was applied in 2 patients. In terms of efficacy, the median time to drainage tube removal was 4 days. Although pretreatment drainage volume was high, post-treatment drainage volume decreased remarkably. With a median follow-up of 2.7 years and 100% follow-up rate, no chronic pelvic pain, lower-limb lymphedema, persistent lymphoceles, or tumor recurrences were observed.

Intraperitoneal OK-432 perfusion is a safe and effective treatment for postoperative lymphatic leakage following gynecologic tumor surgery. It may shorten drainage duration, avoids reoperation, and may offer a therapeutic alternative to current treatments for postoperative lymphatic leakage.