Sclerotherapy with use of doxycycline after percutaneous drainage of postoperative lymphoceles
Sclerotherapy with use of doxycycline after percutaneous drainage of postoperative lymphoceles
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DOI：
10.1016/s1051-0443(07)61407-9
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发表时间：
2001-01-01
影响因子：
2.9
通讯作者：
Waldman, DL
中科院分区：
文献类型：
--
作者：
Caliendo, MV;Lee, DE;Waldman, DL
目的：评价强力霉素作为硬化剂在经皮淋巴细胞术后引流术中的应用。材料与方法：18例有症状的术后淋巴囊肿患者（21例）经皮引流治疗，平均时间10.8天。当患者无症状，引流速度减慢至小于30ml /d，随访影像学（CT或US）显示淋巴囊肿接近完全或完全溶解时，进行硬化治疗。多西环素（500mg）联合1%利多卡因（5mt），通过管排出剩余淋巴细胞液后，用注射器向腔内灌注。在可能的情况下，指导患者在接下来的一小时内进行一系列的动作，以使硬化剂均匀地分布在整个腔内。1小时后，从腔内吸出硬化剂，取出引流管。3例有4个淋巴囊肿的患者在经皮插入引流管和淋巴囊肿抽吸后立即接受了硬化治疗。没有患者既往接受过任何药物治疗的硬化。结果：18例患者中17例术后淋巴细胞得到成功治疗。21例淋巴细胞瘤治疗中有17例取得初步成功。3例患者有4例淋巴囊肿复发。通过反复引流和硬化治疗，4例复发中有3例成功治疗。1例淋巴囊肿复发后继续给予1g强力霉素治疗。该患者接受了成功的手术修复。没有与强力霉素硬化相关的并发症。初次和复发性淋巴囊肿的平均引流时间为10.8天（范围0-30天）。结论：强力霉素经皮引流硬化治疗是一种简便、安全、经济、有效的治疗术后淋巴细胞的方法。
PURPOSE: To assess the use of doxycycline as a sclerosing agent after percutaneous drainage of postoperative lymphoceles.MATERIALS AND METHODS: Symptomatic postoperative lymphoceles (n = 21) in 18 patients were treated by percutaneous tube drainage for an average of 10.8 days. Sclerosis was performed when the patient became asymptomatic, drainage had slowed to less than 30 mL/d and follow-up imaging (CT or US) showed either near complete or total resolution of the lymphocele. Doxycycline (500 mg) combined with 1% lidocaine (5 mt) was instilled into the cavity with use of a syringe after any remaining lymphocele fluid was removed through the tube. When possible, patients were instructed to perform a series of maneuvers for the next hour to distribute the sclerosing agent evenly throughout the cavity. After I hour, the sclerosing agent was aspirated from the cavity and the drainage tube was removed. Three patients with four lymphoceles underwent sclerotherapy immediately after percutaneous insertion of a drainage tube and aspiration of the lymphocele. No patients underwent previous sclerosis with any agent.RESULTS: Successful treatment of postoperative lymphoceles was achieved in 17 of 18 patients. Primary success was achieved in 17 of 21 lymphoceles treated. There were four lymphocele recurrences in three patients. Three of the four recurrences were successfully treated by means of repeated drainage and sclerotherapy. One recurrent lymphocele persisted after re-treatment with 1 g of doxycycline. This patient underwent successful surgical repair. There were no complications related to doxycycline sclerosis. The mean duration of drainage for initial and recurrent lymphoceles was 10.8 days (range, 0-30 days).CONCLUSION: Sclerotherapy with use of doxycycline after percutaneous drainage is an easy, safe, inexpensive, and effective means of treating postoperative lymphoceles.