盆腔淋巴结清扫术后淋巴漏和淋巴囊肿的研究进展

淋巴漏和淋巴囊肿是泌尿外科盆腔淋巴结清扫术后常见的并发症,临床定义不明确,治疗方案多样而效果不确切,相关研究较少,无相关诊疗指南。本文主要对泌尿外科盆腔淋巴结清扫术后淋巴漏和淋巴囊肿的发生机制、高危因素、临床诊断、治疗方案和预防措施等方面进行综述。淋巴漏和淋巴囊肿发生机制包括淋巴液漏出和渗出;高危因素有高龄、开放手术和围手术期使用抗凝药物等;大部分患者通过营养管理、经皮导管硬化治疗等保守治疗可治愈;预防措施以封闭淋巴管及残端为主。

The research advances on patients with lymphorrhea and lymphocele after urological pelvic lymph node dissection

Lymphorrhea and lymphocele are the common complications after urological pelvic lymph node dissection,which are difficult to diagnose and treat.Up to now,a few studies of lymphorrhea and lymphocele were reported,and there is no relevant diagnosis and treatment guideline.The pathogenesis,treatment and prevention of lymphorrhea and lymphocele formation after urological pelvic lymphadenectomy were reviewed in this article.The mechanism of occurrence includes leakage and exudation of lymph-vessels.The high risk factors are old age,open surgery and perioperative use of anticoagulants.Most patients can be cured by nutrition management and percutaneous catheter sclerotherapy.Closing lymph-vessels and stumps may paly an important role in prevetion of lymphorrhea and lymphocele.