Лимфатические кисты после хирургического лечения онкогинекологических больных: факторы риска, диагностика и лечение
https://doi.org/10.17650/1994-4098-2018-14-4-72-79
Аннотация
Лимфатические кисты, или лимфоцеле – одно из самых частых осложнений тазовой и парааортальной лимфодиссекции у онкогинекологических больных. Несмотря на широкую встречаемость данного осложнения, в современной литературе не определены оптимальные рекомендации по лечению и диагностике лимфоцеле. В статье приводится обсуждение и анализ данных литературы о частоте возникновения лимфатических кист, факторах риска их формирования и существующих методах диагностики и лечения.
Ключевые слова
Об авторах
Т. Т. Роговская
ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Петрова» Минздрава России
Россия
Россия
Татьяна Томовна Роговская
197758 Санкт-Петербург, пос. Песочный, ул. Ленинградская, 68
И. В. Берлев
ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Петрова» Минздрава России;
Россия
Россия
197758 Санкт-Петербург, пос. Песочный, ул. Ленинградская, 68,
191015 Санкт-Петербург, ул. Кирочная, 41
Список литературы
1. Ballester M., Bendifallah S., Daraï E. European guidelines (ESMO-ESGOESTRO consensus conference) for the management of endometrial cancer. Bull Cancer 2017;104(12):1032–8. PMID: 29173977. DOI: 10.1016/j.bulcan.2017.10.006.
2. Cibula D., Pötter R., Planchamp F. et al. The European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology guidelines for the management of patients with cervical cancer. Radiother Oncol 2018;127(3):404–16. PMID: 29728273. DOI: 10.1016/j.radonc.2018.03.003.
3. Weinberger V., Cibula D., Zikan M. Lymphocele: prevalence and management in gynecological malignancies. Expert Rev Anticancer Ther 2014;14(3):307–17. PMID: 24483760. DOI: 10.1586/14737140.2014.866043.
4. Ghezzi F., Uccella S., Cromi A. et al. Lymphoceles, lymphorrhea, and lymphedema after laparoscopic and open endometrial cancer staging. Ann Surg Oncol 2012;19(1):259–67. PMID: 21695563. DOI: 10.1245/s10434-011-1854-5.
5. Ilancheran A., Monaghan J.M. Pelvic lymphocyst – a 10-year experience. Gynecol Oncol 1988;29(3):333–6. PMID: 3345953.
6. Mori N. Clinical and experimental studies on the so-called lymphocyst which develops after radical hysterectomy in cancer of the uterine cervix. J Jpn Obstet Gynecol Soc 1955;2(2):178–203. PMID: 13286539.
7. Tam K.F., Lam K.W., Chan K.K., Ngan H.Y. Natural history of pelvic lymphocysts as observed by ultrasonography after bilateral pelvic lymphadenectomy. Ultrasound Obstet Gynecol 2008;32(1):87–90. PMID: 18548478. DOI: 10.1002/uog.5345.
8. McMahon C.J., Rofsky N.M., Pedrosa I. Lymphatic metastases from pelvic tumors: anatomic classification, characterization, and staging. Radiology 2010;254:31–46. PMID: 20032141. DOI: 10.1148/radiol.2541090361.
9. Lengele B., Scalliet P. Anatomical bases for the radiological delineation of lymph node areas. Part III: Pelvis and lower limbs. Radiother Oncol 2009;92(1):22–33. PMID: 19095323. DOI: 10.1016/j.radonc.2008.11.007.
10. Hedgire S.S., Pargaonkar V.K., Elmi A. et al. Pelvic nodal imaging. Radiol Clin North Am 2012;50(6):1111–25. PMID: 23122041. DOI: 10.1016/j.rcl.2012.08.002.
11. Tinelli A., Mynbaev O.A., Tsin D.A. et al. Lymphocele prevention after pelvic laparoscopic lymphadenectomy by a collagen patch coated with human coagulation factors: a matched case-control study. Int J Gynecol Cancer 2013;23(5):956–63. PMID: 23574881. DOI: 10.1097/IGC.0b013e31828eeea4.
12. Yin H., Gui T. Comparative analyses of postoperative complications and prognosis of different surgical procedures in stage II endometrial carcinoma treatment. Onco Targets Ther 2016;9:781–6. PMID: 26937200. DOI: 10.2147/OTT.S95806.
13. Kim Y.H., Shin H.J., Ju W., Kim S.C. Prevention of lymphocele by using gelatinthrombin matrix as a tissue sealant after pelvic lymphadenectomy in patients with gynecologic cancers: a prospective randomized controlled study. J Gynecol Oncol 2017;28(3):e37. PMID: 28382800. DOI: 10.3802/jgo.2017.28.e37.
14. Hiramatsu K., Kobayashi E., Ueda Y. et al. Optimal timing for drainage of infected lymphocysts after lymphadenectomy for gynecologic cancer. Int J Gynecol Cancer 2015;25(2):337–41. PMID: 25594145. DOI: 10.1097/IGC.0000000000000353.
15. Kondo E., Tabata T., Shiozaki T. et al. Large or persistent lymphocyst increases the risk of lymphedema, lymphangitis, and deep vein thrombosis after retroperitoneal lymphadenectomy for gynecologic malignancy. Arch Gynecol Obstet 2013;288(3):587–93. PMID: 23455541. DOI: 10.1007/s00404-013-2769-0.
16. Олейник В.В. Лимфатические кисты после расширенных операций по поводу рака шейки матки и тела матки. Автореф. дис. … канд. мед. наук. СанктПетербург, 1996. 25 с.
17. Kim H.Y., Kim J.W., Kim S.H. et al. An analysis of the risk factors and management of lymphocele after pelvic lymphadenectomy in patients with gynecologic malignancies. Cancer Res Treat 2004;36(6):377–83. PMID: 20368832. DOI: 10.4143/crt.2004.36.6.377.
18. Charoenkwan K., Kietpeerakool C. Retroperitoneal drainage versus no drainage after pelvic lymphadenectomy for the prevention of lymphocyst formation in women with gynaecological malignancies. Cochrane Database Syst Rev 2017;6:CD007387. DOI: 10.1002/14651858.CD007387.pub4.
19. Achouri A., Huchon C., Bats A.S. et al. Complications of lymphadenectomy for gynecologic cancer. Eur J Surg Oncol 2013;39(1):81–6. PMID: 23117018. DOI: 10.1016/j.ejso.2012.10.011.
20. Zikan M., Daniela F., Pinkavova I. et al. A prospective study examining the incidence of asymptomatic and symptomatic lymphoceles following lymphadenectomy in patients with gynecological cancer. Gynecol Oncol 2015;137(2):291–8. PMID: 25720294. DOI: 10.1016/j.ygyno.2015.02.016.
21. Symmond R. Morbidity and complications of radical hysterectomy with pelvic lymph node dissection. Am J Obstet Gynecol 1966;94(5):663–78. PMID: 5906590.
22. Степанов С.О., Новикова Е.Г., Скрепцова Н.С. Ультразвуковая диагностика и тактика при лимфоцеле после онкогинекологических операций. Сибирский онкологический журнал 2009;2(32):25–30.
23. De Blasis I., Vinci V., Sergi M.E. et al. Early and late onset complications of gynaecologic surgery: a multimodality imaging approach. Facts Views Vis Obgyn 2017;9(1):5–14. PMID: 28721179.
24. Vansonnenberg E., Wittich G.R., Casola G. et al. Lymphoceles: imaging characteristics and percutaneous management. Radiology 1986;161(3):593–6. PMID: 3538133. DOI: 10.1148/radiology.161.3.3538133.
25. Францев Д.Ю. Послеоперационные лимфатические кисты таза: аналитический обзор. Клиническая и экспериментальная хирургия. Журнал им. акад. Б.В. Петровского 2015;(4):113–20.
26. Petru E., Tamussino K., Lahousen M. et al. Pelvic and paraaortic lymphocysts after radical surgery because of cervical and ovarian cancer. Am J Obstet Gynecol 1989;161(4):937–41. PMID: 2801842.
27. Sahbaz A., Gungorduk K., Gulseren V. et al. What are the risk factors for lymphocyst formation apart from lymphnode dissection and lymphnode count in gynecologic malignancy? Geburtsh Frauenheilk 2016;76(4):403–7. DOI: 10.1055/s-0041-110804.
28. Кедрова А.Г., Шабловский О.Р., Леваков С.А. и др. Возможности применения низкомолекулярных гепаринов в комплексном лечении женщин с опухолями женской репродуктивной системы. Опухоли женской репродуктивной системы 2017;13(2):47–55.
29. Baraem Y., Ahn H., Kim M. et al. Nomogram predicting risk of lymphocele in gynecologic cancer patients undergoing pelvic lymph node dissection. Obstet Gynecol Sci 2017;60(5):440–8. PMID: 28989920. DOI: 10.5468/ogs.2017.60.5.440.
30. Van Nagell J., Schweitz D. Surgical adjuncts in radical hysterectomy and pelvic lymphadenectomy. Surg Gynecol Obstet 1976;143(5):735–7. PMID: 790612.
31. Бохман Я.В. Руководство по онкогинекологии. Л.: Медицина, 1989. 464 c.
32. Benedetti-Panici P., Maneschi F., Cutillo G. et al. A randomized study comparing retroperitoneal drainage with no drainage after lymphadenectomy in gynecologic malignancies. Gynecol Oncol 1997;65(3):478–82. PMID: 9190979.
33. Franchi M., Trimbos J., Zanaboni F. et al. Randomised trial of drains versus no drains following radical hysterectomy and pelvic lymph node dissection: a European Organisation for Research and Treatment of Cancer-Gynaecological Cancer Group (EORTC-GCG) study in 234 patients. Eur J Cancer 2007;43(8):1265–8. PMID: 17466514. DOI: 10.1016/j.ejca.2007.03.011.
34. Suzuki M., Ohwada M., Sato I. Pelvic lymphocysts following retroperitoneal lymphadenectomy: retroperitoneal partial “no-closure” for ovarian and endometrial cancers. J Surg Oncol 1998;68(3):149–52.
35. Thome Saint Paul M., Bremond A., Rochet Y. Absence of peritonization after pelvic cancer surgery. Results in 157 cases. J Gynecol Obstet Biol Reprod 1991;20(7):957–60.
36. Franchi M., Ghezzi F., Zanaboni F. et al. Nonclosure of peritoneum at radical abdominal hysterectomy and pelvic node dissection: a randomized study. Obstet Gynecol 1997;90(4 Pt 1):622–7. PMID: 9380327.
37. Radosa M.P., Diebolder H., Camara O. et al. Laparoscopic lymphocele fenestration in gynaecological cancer patients after retroperitoneal lymph node dissection as a first-line treatment option. BJOG 2013;120(5):628–36. PMID: 23320834. DOI: 10.1111/1471-0528.12103.
38. Karcaaltincaba M., Akhan О. Radiologic imaging and percutaneous treatment of pelvic lymphocele. Eur J Radiol 2005;55(3):340–54. PMID: 15885959. DOI: 10.1016/j.ejrad.2005.03.007.
39. Kim J.K., Jeong Y.Y., Kim Y.H. et al. Postoperative pelvic lymphocele: treatment with simple percutaneous catheter drainage. Radiology 1999;212(2):390–4.
40. Conte M., Panici P.B., Guariglia L. et al. Pelvic lymphocele following radical para-aortic and pelvic lymphadenectomy for cervical carcinoma: incidence rate and percutaneous management. Obstet Gynecol 1990;76(2):268–71. PMID: 2196500.
41. Teruel J.L., Escobar E.M., Quereda C. et al. A simple and safe method for management of lymphocele after renal transplantation. J Urol 1983;130(6):1058–9. PMID: 6358528.
42. Alago W.Jr., Deodhar A., Michell H. et al. Management of postoperative lymphoceles after lymphadenectomy: percutaneous catheter drainage with and without povidone-iodine sclerotherapy. Cardiovasc Intervent Radiol 2013;36(2):466–71. PMID: 22484702. DOI: 10.1007/s00270-012-0375-3.
43. Rivera M., Marcen R., Burgos J. et al. Treatment of posttransplant lymphocele with povidone-iodine sclerosis: long-term follow-up. Nephron 1996;74(2):324–7. PMID: 8893149. DOI: 10.1159/000189329.
44. Zuckerman D.A., Yeager T.D. Percutaneous ethanol sclerotherapy of postoperative lymphoceles. Am J Roentgenol 1997;169(2):433–7. PMID: 9242748. DOI: 10.2214/ajr.169.2.9242748.
45. Elsandabesee D., Sharma B., Preston J. et al. Sclerotherapy with bleomycin for recurrent massive inguinal lymphoceles following partial vulvectomy and bilateral lymphadenectomy – case report and literature review. Gynecol Oncol 2004;92(2):716–8. PMID: 14766274. DOI: 10.1016/j.ygyno.2003.11.007.
46. Fernandes A.S., Costa A., Mota R. et al. Bleomycin sclerotherapy for severe symptomatic and persistent pelvic lymphocele. Case Rep Obstet Gynecol 2014;2014:624803. DOI: 10.1155/2014/624803.
47. Kurata H., Aoki Y., Tanaka K. Simple one-step catheter placement for the treatment of infected lymphocele. Eur J Obstet Gynecol Reprod Biol 2003;106(1):69–71. PMID: 12475585.
48. Kawamura I., Hirashima Y., Tsukahara M. et al. Microbiology of pelvic lymphocyst infection after lymphadenectomy for malignant gynecologic tumors. Surg Infect (Larchmt) 2015;16(3):244–6. PMID: 25651071. DOI: 10.1089/sur.2014.021.
Рецензия
Для цитирования:
Роговская Т.Т., Берлев И.В. Лимфатические кисты после хирургического лечения онкогинекологических больных: факторы риска, диагностика и лечение. Опухоли женской репродуктивной системы. 2018;14(4):72-79. https://doi.org/10.17650/1994-4098-2018-14-4-72-79
For citation:
Rogovskaya Т.Т., Berlev I.V. Lymphatic cysts after gynecological cancer surgery: risk factors, diagnosis and treatment. Tumors of female reproductive system. 2018;14(4):72-79. (In Russ.) https://doi.org/10.17650/1994-4098-2018-14-4-72-79
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