Percutaneous ethanol sclerotherapy of postoperative lymphoceles

The purpose of this study was to describe our experience with ethanol sclerotherapy of postoperative lymphoceles.

We conducted a retrospective review of 32 patients who in a 6-year period underwent percutaneous ethanol sclerotherapy for the management of postoperative lymphoceles. Twenty-three patients had undergone staging lymphadenectomy for malignant tumors, eight patients had undergone renal transplantation, and one patient had undergone vascular surgery. Of the 32 patients in the study group, eight (25%) had undergone previous aspiration or drainage, and three patients (9%) had undergone surgical lymphocelectomy. Patients were treated by percutaneous drainage under fluoroscopic, sonographic, or CT guidance. Sclerotherapy was done with absolute ethanol. Follow-up was conducted by review of clinical charts and imaging studies and by contacting the patient when necessary.

Technical success was achieved in 30 patients (94%), with resolution of lymphocele shown by clinical and imaging findings. Treatment was unsuccessful in two patients (6%), and two patients (6%) had recurrences. Three patients (9%) subsequently underwent surgical treatment of the lymphoceles. Of these three patients, one had a lymphocele recur after surgery, which was then successfully treated with sclerotherapy. The average duration of catheter placement was 19 days. Complications, all minor, included catheter-related infections treated with antibiotics in three patients (9%) and catheter dislodgment that required repeated drainage procedures in two patients (6%). Clinical follow-up averaged 25 months.

Percutaneous ethanol sclerotherapy is a safe and effective treatment for postoperative lymphoceles. The technical success rate is high, the recurrence rate is low, and the complication rate is acceptable. Percutaneous sclerotherapy of lymphoceles is a less invasive alternative to surgical treatment.