[Radiotherapeutic management of lymphatic fistulas : An effective but disregarded therapy option]

Chirurg. 2017 Apr;88(4):311-316. doi: 10.1007/s00104-016-0352-5.
[Article in German]

Abstract

Background: Lymphatic fistulas and lymphoceles are known complications after vascular surgery of the groin and after extended surgical interventions in the pelvic region. Unfortunately, conservative standard therapies are not always successful.

Objectives: Evaluation of the therapeutic efficacy and related side effects of percutaneous low-dose irradiation in patients with lymphorrhea and definition of its importance.

Material and methods: Current presentation of previously published case series, reviews and guidelines.

Results: The use of low-dose irradiation therapy with single doses of 0.3-0.5 Gy leads to a cessation of the lymphatic flow in a high percentage of patients when standard therapies do not show a sufficient effect. With cessation of lymphorrhea irradiation should be terminated. Acute side effects have not been reported and the risk of tumor induction is almost negligible.

Conclusion: Low-dose irradiation is an effective and very well-tolerated therapeutic alternative in the treatment of lymphatic fistulas and lymphorrhea when conservative therapies are unsuccessful.

Keywords: Low-dose irradiation; Lymphatic fistula; Lymphocele; Lymphorrhea; Radiotherapy.

Publication types

  • Review

MeSH terms

  • Cone-Beam Computed Tomography / methods
  • Dose Fractionation, Radiation
  • Female
  • Fistula / radiotherapy*
  • Humans
  • Inguinal Canal
  • Lymph Node Excision*
  • Lymphatic Diseases / radiotherapy*
  • Lymphatic Irradiation / methods*
  • Lymphocele / radiotherapy
  • Male
  • Postoperative Complications / radiotherapy*
  • Practice Guidelines as Topic
  • Radiotherapy Dosage
  • Radiotherapy, Computer-Assisted / methods
  • Radiotherapy, Intensity-Modulated / methods
  • Treatment Outcome