A case of successful multidisciplinary intervention for refractory lymph ascites after pelvic lymph node dissection
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- Fukui Nozomi
- Department of Obstetrics and Gynecology, The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka
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- Kozono Yuki
- Department of Obstetrics and Gynecology, The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka
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- Yamamoto Rumiko
- Department of Fetal Maternal Medicine, Osaka Women's and Children's Hospital, Osaka
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- Takaori Aya
- Department of Obstetrics and Gynecology, The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka
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- Taga Atsuko
- Department of Obstetrics and Gynecology, The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka
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- Hata Saori
- Department of Obstetrics and Gynecology, The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka
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- Yamamoto Aya
- Department of Obstetrics and Gynecology, The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka
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- Okuda Akiko
- Department of Obstetrics and Gynecology, The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka
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- Yoshioka Yumiko
- Department of Obstetrics and Gynecology, The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka
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- Ishikawa Namiko
- Department of Plastic Surgery, The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka
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- Higuchi Toshihiro
- Department of Obstetrics and Gynecology, The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka
Bibliographic Information
- Other Title
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- 集学的治療により制御しえた骨盤内リンパ節郭清術後難治性リンパ腹水の1例
- シュウガクテキ チリョウ ニ ヨリ セイギョ シエタ コツバン ナイ リンパセツカクセイ ジュツゴ ナンチセイ リンパ フクスイ ノ 1レイ
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Abstract
<p>Lymphorrhea is a relatively rare postoperative complication after retroperitoneal lymph node dissection. Normally, a lymphatic leakage closes spontaneously before it becomes symptomatic. However, some severe, prolonged cases require immediate treatment. Here, we report a case requiring a multidisciplinary intervention for a diagnosis and ascites effusion control after radical hysterectomy. A 41-year-old nulliparous woman with a chief complaint of abnormal vaginal bleeding was referred to our institution. We performed radical hysterectomy, including pelvic lymph node dissection after neoadjuvant chemotherapy based on a cervical cancer stage IIB diagnosis. On postoperative day 52, massive ascitic fluid without chyle developed. Conservative treatment failed to control the ascites, and approximately 36 L of ascites was drained over three months. Subsequent lipoprotein analysis of the ascites detected chylomicron, resulting in a lymph ascites diagnosis owing to postoperative lymph leakage. We performed lymph embolization by lymphangiography and ligation of lymphatic leakage by laparotomy. Finally, we performed lymphaticovenular anastomosis, which relieved the lower limb lymphedema without causing ascites relapse. If ascitic fluid is observed after lymph node dissection, lymphatic ascites should be considered regardless of the presence of chyle.</p>
Journal
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- Japanese Journal of Gynecological Oncology
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Japanese Journal of Gynecological Oncology 40 (1), 1-9, 2022-01-25
Japan Society of Gynecologic Oncology
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Details 詳細情報について
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- CRID
- 1390859856939135360
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- NII Book ID
- AA11308546
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- ISSN
- 24368156
- 13478559
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- NDL BIB ID
- 032005040
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- Text Lang
- ja
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- Data Source
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- JaLC
- NDL
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- Abstract License Flag
- Allowed