CardioVascular and Interventional Radiology

, Volume 30, Issue 2, pp 237–240 | Cite as

Percutaneous Transcatheter Ethanol Sclerotherapy and Catheter Drainage of Postoperative Pelvic Lymphoceles

  • Okan Akhan
  • Musturay Karcaaltincaba
  • Mustafa N. Ozmen
  • Devrim Akinci
  • Deniz Karcaaltincaba
  • Ali Ayhan


The aim of this study is to investigate the efficacy and long-term results of percutaneous transcatheter ethanol sclerotherapy (PTES) for postoperative pelvic lymphocele treatment. Fifty-two patients who were referred for lymphocele treatment were included in this study. Sixty lymphoceles of 52 patients were treated by percutaneous treatment with or without ethanol sclerotherapy. Lymphoceles developed in 47 and 5 patients, who underwent gynecologic malignancy operation (31 ovarian cancer, 6 cervix cancer, 10 endometrial cancer) and renal transplantation, respectively. Lymphoceles were catheterized by ultrasonography and fluoroscopy guidance using the Seldinger technique. Lymphoceles smaller than 150 mL underwent single-session ethanol sclerotherapy and the others were treated by multiple-session ethanol scleortherapy. In 10 patients, percutaneous ethanol sclerotherapy could not be performed and they were treated only by percutaneous catheter drainage. The mean lymphocele volume was 329 mL (15–2900 mL). The mean catheterization duration was 11.8 days (1–60 days). The mean follow up time was 25.8 months (2–64 months). The initial treatment was successful in 46 out of 50 (91%) lymphoceles treated with PTES and 7 out of 10 (70%) lymphoceles treated with percutaneous catheter drainage. Minor complications (secondary infection and catheter dislodgement) were noted in seven (11.6%) patients. Recurrence developed in four and three patients who were treated by PTES and percutaneous catheter drainage, respectively. Five of these patients were treated with PTES without further recurrence. Percutaneous transcatheter ethanol sclerotherapy is an effective and reliable method for the treatment of postoperative lymphoceles.


Lymphocele Lymphocyst Percutaneous Ethanol treatment Drainage 


  1. 1.
    Dodd.GD, Rutledge F, Wallace S (1970) Postoperative pelvic lymphocysts. Am J Roentgenol 108:312–323Google Scholar
  2. 2.
    van Sonnenberg E, Wittich GR, Casola G, et al. (1986) Lymphoceles: Imaging characteristics and percutaneous management. Radiology 161:593–596Google Scholar
  3. 3.
    Braun WE, Banowsky LH, Straffon RA (1974) Lymphoceles associated with renal transplantation: Report of 15 cases and review of the litetarure. Am J Med 57:714–729PubMedCrossRefGoogle Scholar
  4. 4.
    Glass LL, Cockett AT (1998) Lymphoceles: Diagnosis and management in urologic patients. Urology 51(5A Suppl):135–140PubMedCrossRefGoogle Scholar
  5. 5.
    Karcaaltincaba M, Akhan O (2005) Radiologic imaging and percutaneous treatment of pelvic lymphocele. Eur J Radiol 55:340–354PubMedCrossRefGoogle Scholar
  6. 6.
    Kay R, Fuchs E, Barry JM (1980) Management of postoperative pelvic lymphoceles. Urology 15(4):345–347PubMedCrossRefGoogle Scholar
  7. 7.
    Khauli RB, Stoff JS, Lovewell T, et al. (1993) Post-transplant lymphoceles: A critical look into the risk factors, pathophysiology and management. J.Urol 150(1):22–26PubMedGoogle Scholar
  8. 8.
    Spring DB, Schroeder D, Babu S, et al. (1981) Ultrasonic evaluation of lymphocele formation after staging lymphadenectomy for prostatic carcinoma. Radiology 141(2):479–483PubMedGoogle Scholar
  9. 9.
    La Fianza A, Campani R, Dore R, et al. (1993) CT in the diagnosis and treatment of lymphoceles following gynecologic cancer surgery. Radiol.Med 86:106–115PubMedGoogle Scholar
  10. 10.
    Conte M, Panici PB, Guariglia L, et al. (1990) Pelvic lymphocele following radical paraaortic and pelvic lymphadenectomy for cervical carcinoma: Incidence rate and percutaneous management. Obstet Gynecol 76:268–271PubMedGoogle Scholar
  11. 11.
    Petru E, Tamussino K, Lahousen M, et al. (1989) Pelvic and paraaortic lymphocysts after radical surgery because of cervical and ovarian cancer. Am J Obstet Gynecol 161(4):937–941PubMedGoogle Scholar
  12. 12.
    Charkviani L, Kekelidze N, Charkviani T (2000) Management of lymphocysts after cervical carcinoma surgery. Eur J Gynaecol Oncol 21(5):487–490PubMedGoogle Scholar
  13. 13.
    Livingstone WD, Confer DJ, Smith RB (1980) Large lymphoceles resulting from retroperitoneal lymphadenectomy. J Urol 124:543–546Google Scholar
  14. 14.
    Gill IS, Hodge EE, Munch LC, et al. (1995) Transperitoneal marsupialization of lymphoceles: A comparison of laparoscopic and open techniques. J.Urol 153(3 Pt 1):706–711PubMedGoogle Scholar
  15. 15.
    Olsson CA, Willscher MK, Filoso AM, et al. (1976) Treatment of posttransplant lymphoceles: Internal versus external drainage. Transplant.Proc 8(3):501–504PubMedGoogle Scholar
  16. 16.
    Schweitzer RT, Cho SI, Kountz SL , et al. (1972) Lymphoceles following renal trasnplantation. Arch Surg 104:42–45Google Scholar
  17. 17.
    Melvin WS, Baumgardner GL, Davies EA, et al. (1997) The laparoscopic management of post-transplant lymphocele. A critical review. Surg.Endosc 11(3):245–248CrossRefGoogle Scholar
  18. 18.
    McCullough CS, Soper NJ, Clayman RV, et al. (1991) Laparoscopic drainage of a posttransplant lymphocele. Transplantation 51(3):725–727PubMedCrossRefGoogle Scholar
  19. 19.
    Hsu TH, Gill IS, Grune MT, et al. (2000) Laparoscopic lymphocelectomy: A multi-institutional analysis. J.Urol 163(4):1096–1098PubMedCrossRefGoogle Scholar
  20. 20.
    Gruessner RW, Fasola C, Benedetti E, et al. (1995) Laparoscopic drainage of lymphoceles after kidney transplantation: Indications and limitations. Surgery 117(3):288–295PubMedCrossRefGoogle Scholar
  21. 21.
    White M, Mueller PR, Ferrucci JT, et al. (1985) Percutaneous drainage of postoperative abdominal and pelvic lymphoceles. Am J Roentgenol 145:1065–1069Google Scholar
  22. 22.
    Spigos D. Capek V (1976) Ultrasonographically guided percutaneous aspiration of lymphoceles following renal transplantation: A diagnostic and therapeutic method. J Clin Ultrasound 4:45–46Google Scholar
  23. 23.
    Jensen SR, Voegeli DR, McDermott JC, et al. (1986) Percutaneous management of lymphatic fluid collections. Cardiovasc Intervent Radiol 9(4):202–204PubMedGoogle Scholar
  24. 24.
    Aronowitz J, Kaplan AL (1983) The management of pelvic lymphocele by the use of percutaneous indwelling catheter inserted with ultrasound guidance. Gynecol Oncol 16:292–295PubMedCrossRefGoogle Scholar
  25. 25.
    Teruel JL, Escobar EM, Quereda C, et al. (1983) A simple and safe method for management of lymphocele after renal transplantation. J Urol 130(6):1058–1059PubMedGoogle Scholar
  26. 26.
    Akhan O, Cekirge S, Ozmen M, et al. (1992) Percutaneous transcatheter ethanol sclerotherapy of postoperative pelvic lymphoceles. Cardiovasc Intervent Radiol 15(4):224–227PubMedGoogle Scholar
  27. 27.
    Sawhney R, D’Agostino HB, Zinck S, et al. (1996) Treatment of postoperative lymphoceles with percutaneous drainage and alcohol sclerotherapy. J Vasc Intervent Radiol 7(2):241–245CrossRefGoogle Scholar
  28. 28.
    Zuckerman DA, Yeager TD (1997) Percutaneous ethanol sclerotherapy of postoperative lymphoceles. Am J Roentgenol 169(2):433–437Google Scholar
  29. 29.
    Kuzuhara K, Nishimori S, Kurooka Y, et al. (1994) Conservative treatment of lymphocele after renal transplantation, using 95% ethanol instillation. Transplant.Proc 26(4):1988–1990PubMedGoogle Scholar
  30. 30.
    Kim JK, Jeong YY, Kim YH, et al. (1999) Postoperative pelvic lymphocele: treatment with simple percutaneous catheter drainage. Radiology 212(2):390–394PubMedGoogle Scholar
  31. 31.
    Cohan RH, Saeed M, Schwab SJ, et al. (1988) Povidone-iodine sclerosis of pelvic lymphoceles: a prospective study. Urol Radiol 10(4):203–206PubMedCrossRefGoogle Scholar
  32. 32.
    Cohan RH, Saeed M, Sussman SK, et al. (1987) Percutaneous drainage of pelvic lymphatic fluid collections in the renal transplant patient. Invest Radiol 22:864–867PubMedCrossRefGoogle Scholar
  33. 33.
    Rivera M, Marcen R, Burgos J, et al. (1996) Treatment of posttransplant lymphocele with povidone-iodine sclerosis: Long-term follow-up. Nephron 74(2):324–327PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2007

Authors and Affiliations

  • Okan Akhan
    • 1
  • Musturay Karcaaltincaba
    • 1
  • Mustafa N. Ozmen
    • 1
  • Devrim Akinci
    • 1
  • Deniz Karcaaltincaba
    • 2
  • Ali Ayhan
    • 2
  1. 1.Department of RadiologyHacettepe University School of MedicineAnkaraTurkey
  2. 2.Department of Obstetrics and GynecologyHacettepe University School of MedicineAnkaraTurkey

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