Therapeutic efficacy of ultrasound-guided interventional therapy for postoperative pelvic lymphocysts

doi:10.3877/cma.j.issn.1672-6448.2022.09.014

Abstract

Abstract:

Objective

To assess the therapeutic efficacy of different ultrasound-guided interventions in the treatment of pelvic lymphocysts.

Methods

The data of 36 patients who underwent ultrasound-guided intervention treatment of pelvic lymphocysts after gynecologic carcinoma at the PLA General Hospital from June 2014 to June 2020 were retrospectively analyzed. Ultrasound-guided aspiration, absolute alcohol sclerotherapy, or catheter drainage was utilized in the treatment, and Chi-square tests were conducted to compare the effectiveness rate among different treatments.

Results

The effectiveness rate was 36% (4/11) for ultrasound-guided aspiration, which was effective for the lymphocysts with a size of less than 5 cm with the combined treatment of aspiration and antibiotic indwelling, 62% (8/13) for ultrasound-guided absolute alcohol sclerotherapy, and 83% (10/12) for ultrasound-guided catheter drainage. For the pelvic lymphocysts with a diameter of >10 cm, ultrasound-guided aspiration was ineffective in one case, ultrasound-guided absolute alcohol sclerotherapy was ineffective in two cases, but ultrasound-guided catheter drainage was effective for all the cases. The effectiveness of ultrasound-guided absolute alcohol sclerotherapy was better than that of ultrasound-guided aspiration, and the effectiveness of ultrasound-guided catheter drainage was better than that of ultrasound-guided absolate alcohol sclerotherapy; there was a statistical difference among the three groups (χ²=12.91, P=0.012).

Conclusion

Ultrasound-guided intervention therapy is safe and effective in the treatment of postoperative pelvic lymphocysts. Among the three ultrasound-guided interventional therapies, ultrasound-guided catheter drainage has the best therapeutic efficacy, especially for larger size lymphocysts, and ultrasound-guided aspiration has the worst effectiveness, though it is effective for smaller size lymphocysts anyway.

Key words: Ultrasound, Interventional therapy, Lymphocyst, pelvic, Catheter drainage

Yanqiu Wang, Longxia Wang, Hong Xu, Qiuyang Li, Ping He, Qin Liu. Therapeutic efficacy of ultrasound-guided interventional therapy for postoperative pelvic lymphocysts[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2022, 19(09): 953-956.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2022.09.014

https://chaosheng.cma-cmc.com.cn/EN/Y2022/V19/I09/953

Figures/Tables 2

References 13

1	Gasparri ML, Ruscito I, Bolla D, et al. The efficacy of fibrin seal-antpatches in reducing the incidence of lymphatic morbidity after radical lymphadenectomy: a meta-analysis [J]. Int J Gynecol Cancer, 2017, 27(6): 1283-1292.
2	蒋芳, 向阳. 妇科恶性肿瘤腹膜后淋巴结切除术路径、要点及并发症防治 [J]. 中国实用妇科与产科杂志, 2017, 33(12): 1233-1237.
3	田林, 赵宏伟. 盆腔淋巴结清扫术后并发淋巴囊肿及感染的研究进展 [J]. 中国妇幼健康研究, 2017, 28(11): 1484-1486.
4	王延洲, 梁志清. 妇科恶性肿瘤盆腔淋巴清扫后淋巴囊肿处理 [J]. 中国实用妇科与产科杂志, 2016, 32(11): 1052-1057.
5	Akhan O, Karcaaltincaba M, Ozmen MN, et al. Percutaneous trans catheter ethanol sclerotherapy and catheter drainage of postoperative pelvic lymphoceles [J]. Cardiovasc Intervent Radiol, 2007, 30(2): 237-240.
6	林蓓, 凌斌, 张师前, 等. 妇科恶性肿瘤盆腔淋巴结切除术后淋巴囊肿诊治专家共识(2020年版) [J]. 中国实用妇科与产科杂志, 2020, 36(10): 959-964.
7	Tam KF, Lam KW, Chan KK, et al. Natural history of pelvic lymphocysts as observed by ultrasonography after bilateral pelvic lymphadenectomy [J].Ultrasound Obstet Gynecol, 2008, 32(1): 87-90.
8	卢淮武, 林仲秋, 周晖, 等. 盆腔淋巴结切除术后盆腔淋巴囊肿形成与防治 [J]. 中国妇产科临床杂志, 2007, 8(4): 308-31.
9	潘明霞, 王颖梅, 闫晔. 子宫内膜癌患者术后盆腔淋巴囊肿感染相关因素及最佳引流时间[J]. 中华医学杂志, 2017, 97(23): 1765-1768.
10	Kondo E, Tabata T, Shiozaki T, et al. Large or persistent lymphocyst increases the risk of lymphedema, lymphangitis, and deep vein thrombosis after retroperitoneal lymphadenectomy for gynecologic malignancy [J]. Arch Gynecol Obstet, 2013, 288(3): 587-593.
11	Klode J, Klotgen K, Korber A, et al. Polidocanol foam sclero-therapy is a new and effective treatment for post-operative lymphorrhea and lymphocele [J]. J Eur Acad Dermatol Venereol, 2010, 24(8): 904-909.
12	许志辉. 超声引导下介入疗法治疗盆腔恶性肿瘤术后淋巴囊肿的效果与安全性分析 [J].中国超声医学杂志, 2019, 35(6): 528-530.
13	马学功. 妇科肿瘤腹膜后淋巴清扫术后淋巴囊肿的防治进展 [J]. 中华医学杂志, 2018, 98(3): 237-240.

疗效	病例	治愈	好转	无效
单纯穿刺抽液组	11	4（36）	0（0）	6（55）
无水乙醇硬化组	13	8（62）	3（23）	2（15）
置管引流组	12	10（83）	2（17）	0（0）
χ²值		12.91
P值		0.012

疗效	病例	治愈	好转	无效
单纯穿刺抽液组	11	4（36）	0（0）	6（55）
无水乙醇硬化组	13	8（62）	3（23）	2（15）
置管引流组	12	10（83）	2（17）	0（0）
χ²值		12.91
P值		0.012

[1]	Qi Lyu, Pinjing Hui, Yafang Ding, Yanhong Yan. Carotid contrast-enhanced ultrasound assessment of plaque vulnerability and its correlation with ischemic stroke [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(10): 1040-1045.
[2]	Lei Ding, Wen Luo, Xiao Yang, Lina Pang, Peidi Zhang, Haijing Liu, Jiani Yuan, Jin Liu. Application of high-frame-rate contrast-enhanced ultrasound in evaluation of imaging features of C-TIRADS 4-5 thyroid nodules [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(09): 887-894.
[3]	Qian Zhang, Jiahui Chen, Xuemeng Gao, Aoxue Zhao, Ying Huang. Value of radiomics features based on high-frame-rate contrast-enhanced ultrasound in differential diagnosis of benign and malignant thyroid nodules [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(09): 895-903.
[4]	Lianhua Zhu, Xiang Fei, Peng Han, Bo Jiang, Nan Li, Yukun Luo. Value of high frame rate contrast-enhanced ultrasound in differential diagnosis of gallbladder polyp lesions [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(09): 904-910.
[5]	Miao Li, Lianhua Zhu, Peng Han, Bo Jiang, Xiang Fei. Evaluation of relationsip between vascular morphology and risk factors for hepatocellular carcinoma by high-frame-rate contrast-enhanced ultrasound [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(09): 911-915.
[6]	Weiping Zhang, Jingling Wang, Zhixing Liu, Li Chen, Fangqun Chen. Characteristics of time-intensity curve of high-frame-rate contrast-enhanced ultrasound in clear cell renal cell carcinoma [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(09): 916-922.
[7]	Jianmin Ding, Zhengyi Qin, Xiang Zhang, Yan Zhou, Hongyu Zhou, Yandong Wang, Xiang Jing. Contrast-enhanced ultrasound versus gadoxetic acid-enhanced magnetic resonance imaging for LI-RADS classification of focal liver lesions ≤3 cm in patients at high risk of hepatocellular carcinoma: a prospective study [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(09): 930-938.
[8]	Dan Han, Ting Wang, Huan Xiao, Lirong Zhu, Jingyu Chen, Yi Tang. Diagnostic value of contrast enhanced ultrasound versus contrast enhanced computed tomography in benign and malignant liver lesions in children [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(09): 939-944.
[9]	Tingting Liu, Yanbing Lin, Shan Wang, Murong Chen, Zijian Tang, Dongling Dai, Bei Xia. Evaluation of metabolic dysfunction-associated fatty liver disease in children by ultrasound-guided attenuation parameter [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(08): 787-794.
[10]	Yanbo Ma, Yang Hua, Guimei Liu, Xiufeng Meng, Liping Cui. Risk factors for carotid atherosclerotic lesions in middle adults [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(08): 822-826.
[11]	Hua Shao, Ziyue Na, Hui Jing, Bo Li, Qiucheng Wang, Wen Cheng. Value of preoperative percutaneous contrast-enhanced ultrasound in diagnosis of axillary sentinel lymph node metastasis and burden in breast cancer [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(08): 849-853.
[12]	Xu Zhang, Jianping Xu, Dongming Su, Caifen Wang, Dali Wang, Wenzhi Zhang. Contrast-enhanced ultrasound features of male breast masses [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(08): 854-859.
[13]	Xining Wu, Peipei Zhang, Zhenhong Qi, Jing Zhang, Ruina Zhao, Hua Meng, Jianchu Li. Quality of ultrasonic diagnosis of retroperitoneal schwannomas and its influencing factors [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(07): 701-704.
[14]	bing Feng, Qiuguo Zou, Zhenbo Liang, Yanming Lu, Yi Zeng, Shumiao Wu. Clinical study of ultrasonic signs and molecular biological indicators of senile non-specific invasive breast cancer [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(01): 48-51.
[15]	Wenyi Zhao, Bingzi Zou, Guanhui Cai, Yongzhi Liu, Hong Wen. Application of ultrasound strain elastography combined with MRI-DWI guided targeted puncture in diagnosis of prostate lesions [J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(9): 988-994.

Please choose a citation manager

Content to export