Intranodal Lymphangiography and Embolization for Management of Iatrogenic Chylous Ascites after Oncological Surgery.
Intranodal Lymphangiography and Embolization for Management of Iatrogenic Chylous Ascites after Oncological Surgery.
- 2024
Available online through MWHC library: 2002 - 2006, Available in print through MWHC library: 1999 - 2006
CONCLUSIONS: INL with or without LE is a safe minimally invasive tool that can help patients with chylous ascites after oncologic surgery who failed conservative treatment avoid more invasive interventions. Copyright © 2024 SIR. Published by Elsevier Inc. All rights reserved. MATERIALS AND METHODS: Retrospective review of records of patients who underwent INL with or without LE from January 2017 to June 2022 was performed. Adult patients with chylous ascites after oncologic surgery referred to interventional radiology after failure of conservative treatment were included. Thirty-nine patients who underwent 55 procedures were included (34 males and 5 females). Data on patient demographics, procedural technique, outcomes, and follow-up were collected. Descriptive statistics were used to illustrate technical success, clinical success, and adverse events. Univariate logistic regression analysis was performed to evaluate factors predicting clinical success. PURPOSE: To investigate the safety and effectiveness of intranodal lymphangiography (INL) and lymphatic embolization (LE) in management of chylous ascites after oncologic surgery. RESULTS: INL was technically successful in 54 of 55 procedures (98%; 95% confidence interval [CI], 90%-100%). A lymphatic leak was identified in 40 procedures, and LE was attempted in 36. LE was technically successful in 33 of the 36 procedures (92%; 95% CI, 78%-98%). Clinical success, defined as resolution of ascites with no need for peritoneovenous shunt placement or additional surgery, was achieved in 22 of 39 patients (56%; 95% CI, 40%-72%). Clinical success was achieved in 18 patients after 1 procedure, and patients who required repeat procedures were less likely to achieve clinical success (odds ratio, 0.16; 95% CI, 0.04-0.66; P = .012). Four grade 1 procedural adverse events were recorded.
English
1051-0443
S1051-0443(24)00193-3 [pii]
*Chylous Ascites
*Embolization, Therapeutic
*Iatrogenic Disease
*Lymphography
*Predictive Value of Tests
Adult
Aged
Aged, 80 and over
Chylous Ascites/dg [Diagnostic Imaging]
Chylous Ascites/et [Etiology]
Chylous Ascites/th [Therapy]
Embolization, Therapeutic/ae [Adverse Effects]
Female
Humans
Male
Middle Aged
Neoplasms/co [Complications]
Neoplasms/su [Surgery]
Radiography, Interventional/ae [Adverse Effects]
Retrospective Studies
Risk Factors
Time Factors
Treatment Outcome--Automated
MedStar Medical Group
Radiology
Journal Article
Available online through MWHC library: 2002 - 2006, Available in print through MWHC library: 1999 - 2006
CONCLUSIONS: INL with or without LE is a safe minimally invasive tool that can help patients with chylous ascites after oncologic surgery who failed conservative treatment avoid more invasive interventions. Copyright © 2024 SIR. Published by Elsevier Inc. All rights reserved. MATERIALS AND METHODS: Retrospective review of records of patients who underwent INL with or without LE from January 2017 to June 2022 was performed. Adult patients with chylous ascites after oncologic surgery referred to interventional radiology after failure of conservative treatment were included. Thirty-nine patients who underwent 55 procedures were included (34 males and 5 females). Data on patient demographics, procedural technique, outcomes, and follow-up were collected. Descriptive statistics were used to illustrate technical success, clinical success, and adverse events. Univariate logistic regression analysis was performed to evaluate factors predicting clinical success. PURPOSE: To investigate the safety and effectiveness of intranodal lymphangiography (INL) and lymphatic embolization (LE) in management of chylous ascites after oncologic surgery. RESULTS: INL was technically successful in 54 of 55 procedures (98%; 95% confidence interval [CI], 90%-100%). A lymphatic leak was identified in 40 procedures, and LE was attempted in 36. LE was technically successful in 33 of the 36 procedures (92%; 95% CI, 78%-98%). Clinical success, defined as resolution of ascites with no need for peritoneovenous shunt placement or additional surgery, was achieved in 22 of 39 patients (56%; 95% CI, 40%-72%). Clinical success was achieved in 18 patients after 1 procedure, and patients who required repeat procedures were less likely to achieve clinical success (odds ratio, 0.16; 95% CI, 0.04-0.66; P = .012). Four grade 1 procedural adverse events were recorded.
English
1051-0443
S1051-0443(24)00193-3 [pii]
*Chylous Ascites
*Embolization, Therapeutic
*Iatrogenic Disease
*Lymphography
*Predictive Value of Tests
Adult
Aged
Aged, 80 and over
Chylous Ascites/dg [Diagnostic Imaging]
Chylous Ascites/et [Etiology]
Chylous Ascites/th [Therapy]
Embolization, Therapeutic/ae [Adverse Effects]
Female
Humans
Male
Middle Aged
Neoplasms/co [Complications]
Neoplasms/su [Surgery]
Radiography, Interventional/ae [Adverse Effects]
Retrospective Studies
Risk Factors
Time Factors
Treatment Outcome--Automated
MedStar Medical Group
Radiology
Journal Article