Journal articles: 'Lymph leakage'

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Modi, G. "Lymph leakage following subclavian vein catheterization." Nephrology Dialysis Transplantation 14, no. 2 (February 1, 1999): 447–48. http://dx.doi.org/10.1093/ndt/14.2.447.

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Kriebs, Anna. "Lymph leakage promotes insulin resistance in obesity." Nature Reviews Endocrinology 17, no. 12 (October 18, 2021): 708. http://dx.doi.org/10.1038/s41574-021-00588-w.

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Yarema, I. V., O. E. Fatuev, N. S. Kozlov, A. G. Tagirova, I. M. Vagabova, A. Sh Hasan, R. A. Simanin, G. M. Korolyuk, and V. V. Safronova. "Postoperative Lymphatic Leakage in Oncosurgical Patients." General Reanimatology 15, no. 2 (April 30, 2019): 13–20. http://dx.doi.org/10.15360/1813-9779-2019-2-13-20.

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Purpose: to evaluate the influence of postoperative lymphatic leakage volume and duration on homokinesis and incidence of postoperative complications in oncosurgury patients underwent different operative interventions.Material and methods. The results of treatment of 310 patients subjected to standard elective surgical intervention for a malignant pathology of different organs with regional lymph node dissection were evaluated. The selection criterion was prolonged (more than 7 days) and prominent (over 50 ml a day) lymphatic leakage during the postoperative period. The fluid discharged during the postoperative period was identified as a lymph by cytology. The diagnosis of a malignant pathology was verified in all patients after histological examination and patients were distributed according to established diagnosis.Results. The duration of lymphatic leakage including the outpatient treatment stage varied from 9 days to 1 year and 2 months depending on the type of surgery. The longest lymphatic leakage occurred in 2 patients after radical mastectomy. During the 1st week of observation in patients with daily lymph losses up to 100 ml, no changes in the blood composition were noted. Prolonged lymphatic leakage (1–2 weeks after operation) in a volume over 100 ml a day resulted in reduced protein content in blood plasma, severe lymphocytopenia, increased platelet count. During the postoperative period, complications were detected in 31 patients; at that, during the 1st week of observation, 27 patients experienced initial lymphatic leakage over 100 ml a day. Analysis of fatal outcomes (7 patients) showed that in all patients the lymphatic leakage exceeded 150 ml a day and lasted 1 to 2 weeks. The longest inpatient time was typical for patients after Wertheim's hysterectomy and cystectomy, whereas the longest outpatient treatment was experienced by patients after radical mastectomy and inguinofemoral lymph node dissection.Conclusion. In case of lymphatic leakage over 100 ml a day in oncosurgury patients, it was necessary to make up protein losses and after 7 days of persistent lymphatic leakage it became necessary to consider use of active surgical tactics aimed at liquidation of lymph losses.

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Puille, M., D. Steiner, R. Bauer, and R. Klett. "Radiation synovectomy of the knee joint." Nuklearmedizin 45, no. 01 (2006): 57–61. http://dx.doi.org/10.1055/s-0038-1623935.

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Summary Aim: Multiple procedures for the quantification of activity leakage in radiation synovectomy of the knee joint have been described in the literature. We compared these procedures considering the real conditions of dispersion and absorption using a corpse phantom. Methods: We simulated different distributions of the activity in the knee joint and a different extra-articular spread into the inguinal lymph nodes. The activity was measured with a gammacamera. Activity leakage was calculated by measuring the retention in the knee joint only using an anterior view, using the geometric mean of anterior and posterior views, or using the sum of anterior and posterior views. The same procedures were used to quantify the activity leakage by measuring the activity spread into the inguinal lymph nodes. In addition, the influence of scattered rays was evaluated. Results: For several procedures we found an excellent association with the real activity leakage, shown by an r² between 0.97 and 0.98. When the real value of the leakage is needed, e. g. in dosimetric studies, simultaneously measuring of knee activity and activity in the inguinal lymph nodes in anterior and posterior views and calculation of the geometric mean with exclusion of the scatter rays was found to be the procedure of choice. Conclusion: When measuring of activity leakage is used for dosimetric calculations, the above-described procedure should be used. When the real value of the leakage is not necessary, e. g. for comparing different therapeutic modalities, several of the procedures can be considered as being equivalent.

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Suzuki, Masanobu, Shinya Morita, and Keiji Iizuka. "A case of idiopathic lymph leakage in the neck." Auris Nasus Larynx 37, no. 4 (August 2010): 535–37. http://dx.doi.org/10.1016/j.anl.2009.11.006.

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Yarema, I. V., S. A. Fursov, S. A. Pulnikov, G. A. Baranov, A. V. Dobryakov, N. S. Kozlov, A. A. Dolzhenko, and G. M. Korolyuk. "Postoperative External Transabdominal Severe Lymphorrea (Case Report)." General Reanimatology 16, no. 5 (November 6, 2020): 37–44. http://dx.doi.org/10.15360/1813-9779-2020-5-37-44.

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Massive lymphorrhea can cause severe dysfunction of organs and systems and result in death due to loss of vital metabolites from the bodyAim. To demonstrate low efficacy of conservative therapy and late lymph duct ligation in continuous massive postoperative lymphorrhea.Results. We treated a patient with previous subtotal gastric resection with single-plane pancreatic resection, D2 lymph node dissection, peritoneal draining due to poorly differentiated carcinoma in the lower third of stomach and total hysterectomy who developed external lymphorrhea through peritoneal drainage tubes 3 days after surgery. A fat-rich diet, endolymphatic sodium etamsylate administration, and lymphatic duct ligation were not successful in terminating the lymph leakage. Despite the intensive care including extracorporeal detoxification, the multi-organ failure progressed and on day 28 after the surgery the patient was pronounced dead.Conclusion. Damage to lymph ducts and lymph nodes can be complicated by massive lymphorrhea. If the source of lymphorrhea can be identified, an urgent surgical intervention is warranted to stop the lymph leakage, as well as the restoration of homeostasis to replenish the lost metabolites and prevent death of the patient.

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Al-Ishaq, Z., S. Gupta, MA Collins, and T. Sircar. "Chyle leak following an axillary sentinel lymph node biopsy for breast cancer in a patient with superior vena caval thrombosis – a case report and review of the literature." Annals of The Royal College of Surgeons of England 100, no. 6 (July 2018): e147-e149. http://dx.doi.org/10.1308/rcsann.2018.0074.

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Chyle leak is a very rare complication following an axillary lymph node dissection. We report a case of chyle leak following sentinel lymph node biopsy in a patient with breast cancer with superior vena caval thrombosis. To our knowledge, this is the first case report of chyle leakage following axillary sentinel lymph node biopsy. We describe the aetiology, prevention and treatment strategy that can be adopted in these patients.

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Cong, Ming-hua, Qi Liu, Wen-hong Zhou, Jian Zhu, Chen-xin Song, and Xing-song Tian. "Six Cases of Chylous Leakage after Axillary Lymph Node Dissection." Onkologie 31, no. 6 (2008): 6. http://dx.doi.org/10.1159/000131218.

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Gao, Xiang, Tang-Shun Wang, Juan Cheng, Xiao-Guang Shi, Ke-Xin Zhou, Ming Xin, Zhi-Guo Ding, and Xiao-Heng Chen. "Multiple surgical radical treatment in axillary lymph nodes: A case report." European Journal of Inflammation 17 (January 2019): 205873921983895. http://dx.doi.org/10.1177/2058739219838951.

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Lymph node tuberculosis is a common clinical bacterial infectious disease. Regional lymph node tuberculosis is often difficult to cure by surgically radical resection. In addition, its recurrence rate is higher, and it can easily cause lymphatic leakage. This case was considered to have left axillary lymph node tuberculosis. A combination of clinical examination, ultrasound, and magnetic resonance imaging examinations were performed before surgery. The surgical procedure performed was left axillary lymph node excision. Postoperative pathology confirmed the lymph node tuberculosis. The patient was given anti-tuberculosis drug treatment with no recurrence after 6 months follow-up. This provides new ideas and methods for the clinical treatment of regional lymph node tuberculosis.

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Ryu, Somi, Byeong Min Lee, Seongjun Won, and Jung Je Park. "A Case Report on the Management of Intractable Chyle Leakage after Left Neck Level V Lymph Node Biopsy." Korean Journal of Otorhinolaryngology-Head and Neck Surgery 64, no. 2 (February 21, 2021): 124–28. http://dx.doi.org/10.3342/kjorl-hns.2020.00087.

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Chyle leakage from the neck, which usually occurs after iatrogenic injury of the thoracic or lymphatic duct, is an uncommon complication of head and neck surgeries, which include neck dissection or thyroidectomy. A small amount of chyle leakage can be treated with conservative approaches, such as nutritional limitation, somatostatin analogues, and wound compression. However, massive or uncontrolled chyle leakage requires surgical exploration of the wound and thoracic duct ligation via the chest or transabdominal thoracic duct embolization can be applied. Here, we report a case of intractable massive chyle leakage in a 78-year-old male after a left neck level V lymph node biopsy, which was not controlled after conservative management and explorative surgery. Various treatment approaches were attempted and successful management of chyle leakage was ultimately achieved by thoracic duct embolization.

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Naranjo-Saltos, Fernando, Alejandro Hallo, Carlos Hallo, Andres Mayancela, and Alejandra Rojas. "Gastrointestinal Cryptococcosis Associated with Intestinal Lymphangiectasia." Case Reports in Medicine 2020 (April 21, 2020): 1–5. http://dx.doi.org/10.1155/2020/7870154.

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Intestinal lymphangiectasia is a pathological dilation of enteric lymphatic vessels resulting in lymph leakage to the intestinal lumen. This chronic lymph leakage leads to a state of immunosuppression secondary to the loss of humoral and cellular components of the immune system and represents a potential risk factor for opportunistic infections. We report a case of protein-losing enteropathy in a seemingly immunocompetent patient. An intestinal histopathological study revealed the unusual association of lymphangiectasia and intestinal cryptococcosis. Although cryptococcal infection is common in immunocompromised patients, intestinal involvement is rarely reported. We found no reports on the association of intestinal cryptococcosis in patients with lymphangiectasia. This case report is the first to describe intestinal cryptococcosis associated with intestinal lymphangiectasia.

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Czepielewski, Rafael, Emma Erlich, Emily Onufer, Shannon Young, Ki-Wook Kim, Peter Wang, Shashi Bala, et al. "OBSTRUCTED LYMPHATIC TRANSPORT AND LEAKAGE DRIVEN BY MESENTERIC TERTIARY LYMPHOID ORGANS IS A FEATURE OF CROHN’S DISEASE MOUSE MODEL." Inflammatory Bowel Diseases 27, Supplement_1 (January 1, 2021): S33—S34. http://dx.doi.org/10.1093/ibd/izaa347.080.

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Abstract Pioneer reports of Crohn’s disease (CD) suggested that impaired lymphatic flow might drive its pathogenesis but remains unsettled. Nodules of tertiary lymphoid organs (TLO) are found in association with collecting lymphatic vessels (CLVs) of the mesentery that normally conducts lymph outflow from the intestine. Whether TLOs affect lymph transport is unknown. In the TNFΔARE mouse model of Crohn’s-like ileitis, TLOs are found in valves regions. Using lymphatic reporters and photoconversion to study cell trafficking from the intestine, our findings indicated that TLOs halts immune cells traveling from the inflamed ileum to the lymph node, effectively trapping DCs, B, and T cells, and impacting the development of microbe tolerogenic regulatory T cells. Lymphatic transport defects were intrinsic to the CLVs because the soluble fluorescent tracer’s passage through TLO was also blocked. Lymph blockage promoted retrograde lymphatic flow returning towards the gut wall due to incapable valves. Moreover, significant lymph leakage was found, specifically at the TLOs. Neutralizing anti-TNF mAb treatment into TNFΔARE mice is ineffective in eliminating TLOs or restoring lymphatic trafficking when administered in female mice with advanced disease. In males, the therapy was able to restore forward flow to the lymph node. However, even in the presence of TNF inhibition, both sexes demonstrated TLO lymph leakage. Thus, mesenteric TLOs that form during chronic ileitis drive broadly impaired lymph transit of molecules and cells from the intestine that is only partially reversible by neutralizing the cytokine cascade underlying the disease and establish a perennial tissue alteration.

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Onishi, Yasuyuki, Yusaku Moribata, Hironori Shimizu, Kosuke Shimizu, Takeshi Sano, Takashi Kobayashi, and Yuji Nakamoto. "Intranodal Lymphangiography during Surgical Repair of Pelvic Lymphorrhea after Radical Cystectomy." Case Reports in Urology 2021 (July 5, 2021): 1–4. http://dx.doi.org/10.1155/2021/7822422.

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Lymphorrhea can develop after various types of surgeries. Surgical closure of the lymphatic leakage point is an effective treatment option. However, it is difficult to identify the leakage point sometimes. Here, we report a case of pelvic lymphorrhea after radical cystectomy for bladder cancer. Identification of the leakage point was difficult during laparoscopic surgical repair of lymphorrhea. Intranodal lymphangiography was performed via the inguinal lymph node by injection of lipiodol, followed by injection of indigo carmine. Laparoscopy revealed extravasation of lipiodol and indigo carmine from the pelvic wall. The leakage point was successfully cauterized using an electric scalpel. Lymphorrhea improved after the surgical repair. This case suggests that intranodal lymphangiography may be useful for detecting the site of lymphatic leakage during the surgical repair of lymphorrhea.

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Tessandier, Nicolas, Imene Melki, Nathalie Cloutier, Isabelle Allaeys, Adam Miszta, Sisareuth Tan, Andreea Milasan, et al. "Platelets Disseminate Extracellular Vesicles in Lymph in Rheumatoid Arthritis." Arteriosclerosis, Thrombosis, and Vascular Biology 40, no. 4 (April 2020): 929–42. http://dx.doi.org/10.1161/atvbaha.119.313698.

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Objective: The lymphatic system is a circulatory system that unidirectionally drains the interstitial tissue fluid back to blood circulation. Although lymph is utilized by leukocytes for immune surveillance, it remains inaccessible to platelets and erythrocytes. Activated cells release submicron extracellular vesicles (EV) that transport molecules from the donor cell. In rheumatoid arthritis, EV accumulate in the joint where they can interact with numerous cellular lineages. However, whether EV can exit the inflamed tissue to recirculate is unknown. Here, we investigated whether vascular leakage that occurs during inflammation could favor EV access to the lymphatic system. Approach and Results: Using an in vivo model of autoimmune inflammatory arthritis, we show that there is an influx of platelet EV, but not EV from erythrocytes or leukocytes, in joint-draining lymph. In contrast to blood platelet EV, lymph platelet EV lacked mitochondrial organelles and failed to promote coagulation. Platelet EV influx in lymph was consistent with joint vascular leakage and implicated the fibrinogen receptor α2bβ 3 and platelet-derived serotonin. Conclusions: These findings show that platelets can disseminate their EV in fluid that is inaccessible to platelets and beyond the joint in this disease.

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Peterson, B. T., D. E. Griffith, J. C. Connelly, and R. W. Tate. "Differential effects of salmeterol on lung endothelial and epithelial leakage in sheep." Journal of Applied Physiology 80, no. 5 (May 1, 1996): 1666–73. http://dx.doi.org/10.1152/jappl.1996.80.5.1666.

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Salmeterol has been shown to prevent the influx of proteins into the air spaces of lungs of guinea pigs given intravenous histamine. To determine whether the salmeterol acts to stabilize the epithelial or endothelial barrier, we ventilated anesthetized sheep with aerosolized salmeterol before infusing histamine intravenously at a rate of 4 micrograms.kg-1.min-1 for 3 h. Changes in endothelial permeability were assessed by measuring the flow of lymph and proteins from the lungs. The influx of proteins into the air spaces was detected by performing single-cycle lavages to measure the concentration of circulating 125I-albumin in the epithelial lining fluid. Intravenous histamine increased the lymph flow to 13.2 +/- 6.8 ml/h compared with the control value of 5.6 +/- 2.8 ml/h (P < 0.05). Histamine also increased the concentration of 125I-albumin in the epithelial lining fluid from 1.8 +/- 0.9 to 8.5 +/- 2.5% of the plasma concentration (P < 0.01) and the postmortem lung water volume from 3.5 +/- 0.5 to 5.0 +/- 0.8 mg/g dry lung wt (P < 0.05). Pretreatment with 2.5 mg of aerosolized salmeterol prevented the influx of proteins into the air spaces and the increase in the postmortem lung water volume but it also increased the lung lymph flow even further to 20.0 +/- 5.6 ml/h (P < 0.05), increased the lymph-to-plasma protein ratio from 0.77 to 0.91, and tripled the increase in alveolar-arterial oxygen gradient caused by histamine alone. Pretreatment with 2.5 mg of intravenous salmeterol had essentially the same effect as salmeterol administered by aerosol. We conclude that salmeterol decreases lung epithelial permeability but increases lung endothelial permeability due to intravenous histamine in sheep.

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Aursnes, I. "Blood Platelet Production and Red Cell Leakage to Lymph during Thrombocytopenia." Scandinavian Journal of Haematology 13, no. 3 (April 24, 2009): 184–95. http://dx.doi.org/10.1111/j.1600-0609.1974.tb00258.x.

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Nezami, Nariman, Sedigeh Abdollahifard, Abolfazl Bohlouli, Afshar Zomorrodi, and Bahram Hashemi. "Effect of lymph leakage on renal allograft outcome from living donors." Saudi Journal of Kidney Diseases and Transplantation 23, no. 4 (2012): 701. http://dx.doi.org/10.4103/1319-2442.98113.

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Kim, Seong Hoon, Jong Hyuk Ahn, Hye Jeong Yoon, Jae Hwan Kim, Young Mi Hwang, Yun Suk Choi, and Jin Wook Yi. "Effect of a Polyglycolic Acid Mesh Sheet (Neoveil™) in Thyroid Cancer Surgery: A Prospective Randomized Controlled Trial." Cancers 14, no. 16 (August 12, 2022): 3901. http://dx.doi.org/10.3390/cancers14163901.

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Papillary thyroid cancer (PTC) is the most common type of thyroid cancer. Surgery for PTC involves resection of the thyroid gland and central lymph node dissection. Central lymph node dissection is associated with an increased amount of fluid from the dissection area and chyle leakage due to thoracic duct injury. There are few studies that deal with reducing fluid drainage and preventing chyle leakage after thyroid surgery with central lymph node dissection. A polyglycolic acid mesh sheet (Neoveil™) has been demonstrated to prevent postoperative fluid leakage in other surgeries. This study aims to evaluate whether a polyglycolic acid mesh sheet can reduce postoperative drainage and chyle leakage in papillary thyroid cancer surgery, and this study was designed as a prospective, open-label, randomized controlled trial in a single university hospital. The patients were randomly assigned to having only fibrin glue used in the central node dissection area (control group) or to having a polyglycolic acid mesh sheet applied after fibrin glue (treatment group). A total of 330 patients were enrolled, of which 5 patients were excluded. A total of 161 patients were included in the treatment group, and 164 patients were included in the control group. The primary outcome was the drainage amount from the Jackson-Pratt drain, and the secondary outcome was the triglyceride level in the drained fluid on the 1st and 2nd postoperative days. The drainage amount was significantly lower in the treatment group on the 2nd postoperative day (60.9 ± 34.9 mL vs. 72.3 ± 38.0 mL, p = 0.005). The sum of drainage amount during the whole postoperative days (1st and 2nd days) was also significantly lower in the treatment group (142.7 ± 71.0 mL vs. 162.5 ± 71.5 mL, p = 0.013). The postoperative triglyceride levels were lower in the treatment group but were not statistically significant (92.1 ± 60.1 mg/dL vs. 81.3 ± 58.7 mg/dL on postoperative day 1, p = 0.104 and 67.6 ± 99.2 mg/dL vs. 53.6 ± 80.4 mg/dL on postoperative day 2, p = 0.162). No adverse effects were observed in the treatment groups during the postoperative 9-month follow-up. Our study suggests that polyglycolic acid mesh sheets can be safely applied to reduce postoperative drainage amount in thyroidectomy patients who need lymph node dissection.

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Seow, Choon, Linda Murray, and Ruth F. McKee. "Surgical pathology is a predictor of outcome in post-operative lymph leakage." International Journal of Surgery 8, no. 8 (2010): 636–38. http://dx.doi.org/10.1016/j.ijsu.2010.07.297.

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Chanana, A. D., and D. D. Joel. "Contamination of lung lymph following standard and modified procedures in sheep." Journal of Applied Physiology 60, no. 3 (March 1, 1986): 809–16. http://dx.doi.org/10.1152/jappl.1986.60.3.809.

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The sheep lung lymph fistula preparation of Staub et al. is reported to be contaminated by systemic lymph. The published estimates of contamination range from 5% (awake sheep) to 60% (anesthetized sheep). In view of these conflicting estimates, we investigated the pre- and postoperative contaminating sources, morphological and functional consequences of the proposed contamination reducing modifications, and base-line lung lymph flow in awake sheep following standard and modified cannulation procedures. Our morphological observations are not compatible with the higher estimates of contamination (25–60%). Evidence of lymph leakage from cauterized lymphatics was found. The lymphatics that appear after diaphragmatic cautery and partial resection of caudal mediastinal lymph node were found to constitute “new” contaminating sources. The lymph flow data from base-line and increased vascular pressure conditions were consistent with the reported low estimates of contamination (5%). We propose simple modifications of the standard procedure of Staub et al. which may be nearly as effective in reducing contamination by extrapulmonary lymph as the more invasive and/or traumatic modifications.

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Chien, Dinh Van, Nguyen Van Huong, Dang Dinh Khoa, Nguyen Van Thuy, Ha Van Quyet, Pham Van Duyet, Pham Van Thuong, and Dang Quaoc Ai. "Totally laparoscopic total gastrectomy with technique of functional end-to-end esophagojejunostomy by linear stapler without previous resection of the esophagus and jejunum." International Surgery Journal 7, no. 11 (October 23, 2020): 3614. http://dx.doi.org/10.18203/2349-2902.isj20204659.

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Background: The technique of esophagojejunostomy in totally laparoscopic total gastrectomy is difficult and had a high frequency of incidents during surgery and anastomotic leakage. We aimed to evaluate the outcomes of the technique of functional end-to-end esophagojejunostomy by linear stapler without previous resection of the esophagus and jejunum in the totally laparoscopic total gastrectomy with D2 lymph node dissection in the treatment of gastric cancer.Methods: A prospective observational study on patients received technique of functional end-to-end esophagojejunostomy by linear stapler without previous resection of esophagus and jejunum between July 2017 to July 2020.Results: We included 70 patients with a mean age of 62.5. There were 80% of patients having tubular adenocarcinoma and papillary adenocarcinoma, 11.4% of patients having tumors in the upper third of the stomach, and 81.4% of patients having tumors in the middle of the stomach. There were 4.2% of cases having incidents during the surgery and 2.8% of cases having complications after the surgery. No anastomotic leakage or death was observed after the surgery. The mean lymph node was 23, and the mean metastatic lymph node was 2.7. The operation time was 203.8 minutes. The mean hospital stay was 8.0 days. The one year survival after the surgery was 97.9%, and two year survival was 93.1%. The mean survival was 35.3 months.Conclusions: TLTG with D2 lymph node dissection using functional end-to-end esophagojejunostomy by linear stapler without previous resection of esophagus and jejunum was safe and effective in gastric cancer treatment.

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Gerken, Andreas Lutz Heinrich, Florian Herrle, Jens Jakob, Christel Weiß, Nuh N. Rahbari, Kai Nowak, Constantin Karthein, et al. "Definition and severity grading of postoperative lymphatic leakage following inguinal lymph node dissection." Langenbeck's Archives of Surgery 405, no. 5 (August 2020): 697–704. http://dx.doi.org/10.1007/s00423-020-01927-7.

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Oba, Takaaki, Mayu Ono, Asumi Iesato, Toru Hanamura, Takayuki Watanabe, Tokiko Ito, Toshiharu Kanai, Kazuma Maeno, and Ken-ichi Ito. "Chylous leakage after axillary lymph node dissection in a patient with breast cancer." Breast Journal 24, no. 3 (October 24, 2017): 438–40. http://dx.doi.org/10.1111/tbj.12934.

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Otsuka, Koji, Satoru Goto, Tomotake Ariyoshi, Takeshi Yamashita, Kentaro Motegi, Rei Kato, Masahiro Kohmoto, et al. "RA04.03: MINIMALLY INVASIVE ESOPHAGECTOMY IN THE LEFT LATERAL DECUBITUS POSITION." Diseases of the Esophagus 31, Supplement_1 (September 1, 2018): 25. http://dx.doi.org/10.1093/dote/doy089.ra04.03.

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Abstract Background We initially performed minimally invasive esophagectomy in a left lateral decubitus position through 5 ports in 1996, and we have now treated over 900 cases using this approach. This position has many benefits, but it also has some drawbacks. We were able to operate with good results after we introduced artificial pneumothorax with CO2 insufflation in 2010. We investigated the short- and long-term outcomes of thoracoscopic surgery for esophageal cancer in the left lateral decubitus position at our institution. Methods From 1996 to 2016, 807 esophageal cancer patients were treated with minimally invasive esophagectomy in the left lateral decubitus position at our hospital. We compared the 289 cases treated in the early period (1996–2005) and 518 cases treated in the late period (2006–2016), in which the procedure was standardized and operator training was established Results The completion rate of thoracoscopic surgery was 99.5%, with the procedure switched to thoracotomy in only 3 patients in whom hemorrhage occurred. The mean intrathoracic operative time was 205.0 min, mean intrathoracic blood loss was 127.3 mL, and mean number of dissected mediastinal lymph nodes was 24.7. The postoperative complications were pneumonia (8.5%), anastomotic leakage (7.5%), and recurrent nerve paralysis (7.8%). The 5-year overall survival rate was 69.5%. Comparison of 289 cases treated in the early period (1996–2005) and 518 cases treated in the late period (2006–2016), revealed significant differences in mean intrathoracic blood loss (174.0 vs. 94.2 mL); number of dissected mediastinal lymph nodes (20.0 vs. 28.4); postoperative hospital stay (33.4 vs. 20.0 days, all P < 0.001); and postoperative anastomotic leakage (13.9% vs. 1.6%, P < 0.0001). In recent operation, we do not have recurrent laryngeal nerve paralysis and hoarseness after we take care of the micro anatomical layer, stretch and thermal damage of recurrent laryngeal nerve when we dissect the lymph node. Conclusion These data indicate significant improvements in intrathoracic blood loss, number of dissected mediastinal lymph nodes, anastomotic leakage, and postoperative hospital stay, reflecting continued improvement of minimally invasive esophagectomy performed in the left lateral decubitus position at our institution. Disclosure All authors have declared no conflicts of interest.

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Schwarz, F., J. Wallmichrath, R. Baumeister, A. Frick, P. Bartenstein, A. Rominger, and M. Weiss. "Chylothorax and chylous as." Nuklearmedizin 54, no. 05 (2015): 231–40. http://dx.doi.org/10.3413/nukmed-0723-15-02.

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SummaryThe aim was to analyze conventional planar scintigraphy and SPECT/CT in patients clinically suspicious for chylothorax or chylous ascites. Lymphoscintigraphy was performed for two reasons: first, to help diagnose chylothorax or -abdomen, by demonstrating diffuse uptake in fluid accumulations, and then secondly, to detect the site of leakage to test the prediction that additional use of SPECT/ CT-technique improves upon the diagnostic value of planar lympho scintigraphy in the baseline detection of thoraco-abdominal lymphatic disorders. Patients, material, methods: From 7/2008-7/2014 a total of 24 consecutive patients (8 woman, 16 men; age, range 31-79 years) presenting with clinical symptoms suspicious for chylothorax and/or chylous ascites were examined by planar lymphoscintigraphy (n = 26) and additional tomographic SPECT/CT- (n = 22) or SPECTtechnique (n = 2). Results: Chylothorax could be scintigraphically confirmed in n = 9, chylous ascites in n = 5 scintigraphies, and excluded in n = 10 patients. In all planar scintigraphy findings of pathological lymph drainage regions (n = 14), SPECT/CT delivered additional relevant information, notably the anatomic localization of the lymphatic leakage. For the baseline detection of thoraco-abdominal lymphatic transport disorders, lymphoscintigraphy showed sensitivity of 88%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 80%. Conclusions: Our findings show that due to the particular advantages presented by tomographic separation of overlapping sources, SPECT/CT specifies better the anatomical sites, improving the localization of lymphatic leakage in aid of planning surgical re-interventions.

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Huang, Bin, Liangbin Jin, Tao Peng, and Zhenglei Fei. "Colorectal Cancer Lymph Node Detection and Anastomotic Safety of Using Carbon Nano-Tracer Following Minimally Invasive Radical Surgery." Journal of Biomedical Nanotechnology 18, no. 8 (August 1, 2022): 2076–80. http://dx.doi.org/10.1166/jbn.2022.3408.

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Objective: The goal of this study is to examine the impact of rectal submucosal injection of nano-carbon suspension injection following neoadjuvant therapy for middle and low rectal cancer on lymph node identification and anastomotic safety. Methods: 45 patients with intermediate-to-low grade rectal cancer admitted to the Ningbo Medical Center Lihuili Hospital between March 2019 and March 2022 had their medical records reviewed retrospectively. Patients in case group were injected with nanocarbon suspension under an anoscope into the rectal submucosa patients in control group were not injected with nanocarbon suspension. The lymph node identification and anastomotic consequences were then compared. Results: There were statistically significant differences between the two groups in the average number of lymph nodes discovered in the observation group and the percentage of patients with more than 12 lymph nodes detected. The percentage of patients with lymph node metastases did not significantly. The rates of complications such leakage, hemorrhage, stenosis, and abscesses around the anastomosis were similar in both groups. Conclusion: Nano carbon lymph node tracking is a safe, simple, and easy-to-operate method for increasing the number of lymph nodes detected in surgical specimens of middle and low rectal cancer after neoadjuvant therapy.

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Iuele, Francesca, Dino Rubini, Corinna Altini, Paolo Mammucci, and Antonio Rosario Pisani. "Lympho-SPECT/CT as a Key Tool in the Management of a Patient with Chylous Ascites." Biomedicines 11, no. 2 (January 19, 2023): 282. http://dx.doi.org/10.3390/biomedicines11020282.

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Chylous ascites is a rare form of ascites usually associated with cirrhosis, abdominal malignancies, surgeries or infections. We presented a case of chylous ascites after robotic laparoscopic prostatectomy (PLDN-RALP), in which the correct diagnosis was achieved by SPECT/CT lymphoscintigraphy. A 72-year-old male developed chylous ascites after surgery and underwent lymphoscintigraphy with radiolabeled albumin nanocolloids for the supplementary study of the lymph flow and to detect a possible site of leakage. The scintigraphic imaging demonstrated the abdominal effusion and lymph stasis in the left iliac region. The combination of planar imaging with SPECT/CT can resolve the assessment of chylous disorders.

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Charan, N. B., G. M. Turk, and D. H. Hey. "Effect of increased bronchial venous pressure on lung lymph flow." Journal of Applied Physiology 59, no. 4 (October 1, 1985): 1249–53. http://dx.doi.org/10.1152/jappl.1985.59.4.1249.

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We postulated that if the bronchial circulation affects lung fluid balance, increases in bronchial venous pressures may influence lung lymph flow. This hypothesis was tested in eight anesthetized sheep prepared with acute lung lymph fistulas. After control data, we increased bronchial venous pressure by infusing saline directly into the bronchial vein at a controlled infusion pressure of 20–25 cmH2O. Evans blue dye (2.5 mg/ml) was added into the saline as a marker for assessing leakage that might occur from either the catheter or the ruptured bronchial veins. Lymph flow was measured every 15 min. Lymph as well as plasma samples were collected every 30 min for measurement of protein. In five sheep we also measured Evans blue dye content both in lymph and plasma to further characterize the role of bronchial circulation in lung fluid balance. The control lymph flow was 1.9 +/- 0.2 ml/15 min, and lymph-to-plasma protein ratio was 0.65 +/- 0.3 (mean +/- SE). With infusion of saline into the bronchial vein, the mean lung lymph flow and lymph-to-plasma protein ratio did not change significantly. There was a progressive increase in dye content both in lymph and plasma. The mean Evans blue dye content in lymph was 0.087, 0.16, and 0.26 microgram/ml, whereas in plasma it was 0.43, 1.15, and 1.45 microgram/ml in samples obtained at 30, 60, and 90 min, respectively. The dye content was significantly higher in the plasma compared with the lymph in all three samples (less than 0.05). Pulmonary arterial pressure, pulmonary capillary wedge pressure, and cardiac output did not change significantly throughout the experiment.

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Nowakowski, Michał, Piotr Małczak, Magdalena Mizera, Mateusz Rubinkiewicz, Anna Lasek, Mateusz Wierdak, Piotr Major, Andrzej Budzyński, and Michał Pędziwiatr. "The Safety of Selective Use of Splenic Flexure Mobilization in Sigmoid and Rectal Resections—Systematic Review and Meta-Analysis." Journal of Clinical Medicine 7, no. 11 (October 27, 2018): 392. http://dx.doi.org/10.3390/jcm7110392.

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Background: According to traditional textbooks on surgery, splenic flexure mobilization is suggested as a mandatory part of open rectal resection. However, its use in minimally invasive access seems to be limited. This stage of the procedure is considered difficult in the laparoscopic approach. The aim of this study was to systematically review literature on flexure mobilization and perform meta-analysis. Methods: A systematic review of the literature was performed using the Medline, Embase and Scopus databases to identify all eligible studies that compared patients undergoing rectal or sigmoid resection with or without splenic flexure mobilization. Inclusion criteria: (1) comparison of groups of patients with and without mobilization and (2) reports on overall morbidity, anastomotic leakage, operative time, length of specimen, number of harvested lymph nodes, or length of hospital stay. The outcomes of interest were: operative time, conversion rate, number of lymph nodes harvested, overall morbidity, mortality, leakage rate, reoperation rate, and length of stay. Results: Initial search yielded 2282 studies. In the end, we included 10 studies in the meta-analysis. Splenic flexure is associated with longer operative time (95% confidence interval (CI) 23.61–41.25; p < 0.001) and higher rate of anastomotic leakage (risk ratios (RR): 1.02; 95% CI 1.10–3.35; p = 0.02), however the length of hospital stay is shorter by 0.42 days. There were no differences in remaining outcomes. Conclusions: Not mobilizing the splenic flexure results in a significantly shorter operative time and a longer length of stay. Further research is required to establish whether flexure mobilization is required in minimally invasive surgery.

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Koike, Masahiko, and Yasuhiro Kodera. "PS01.200: OPEN IVOR LEWIS ESOPHAGECTOMY WITH AN AGGRESSIVE UPPER MEDIASTINAL LYMPH NODE DISSECTION." Diseases of the Esophagus 31, Supplement_1 (September 1, 2018): 106. http://dx.doi.org/10.1093/dote/doy089.ps01.200.

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Abstract Background The Ivor Lewis procedure consists of open subtotal esophagectomy and intrathoracic esophago-gastric anastomosis. Though this procedure is open surgery, it can minimize the risk of anastomotic leakage. This procedure combined with aggressive upper mediastinal lymph node dissection could achieve satisfactory short-term and long-term outcomes. Methods The cases with middle or lower thoracic cancer without metastasis at the cervical area are subjected to this Ivor Lewis procedure. To evade the demerit of thoracotomy, we have employed 1) the 3-field lymphadenectomy in selective patients, 2) the vertical muscle-sparing thoracotomy without transection of muscles and ribs, 3) paravertebral block for postoperative pain. Results A total of 246 patients who underwent subtotal esophagectomy (2011.1–2016.12) were analyzed for short-time postoperative outcomes. In 135 patients of the Ivor-Lewis group, prevalence of anastomotic leakage, anastomotic stricture recurrent nerve palsy and the morbidity, defined as Clavien-Dindo classification 2 or further, was 0%, 0.7% and 21% respectively. On the other hand, the incidence of these increased significantly in 111 patients who underwent cervical anastomosis, 10%, 6.3% and 47% respectively. Though Ivor-Lewis was open surgery, 83% patients in the Ivor Lewis group achieved 30 m walking at the ward within postoperative day 2 and the median length of postoperative hospital stay was 16 days (10–83). The survival according to our therapeutic strategy was analyzed in 352 patients who underwent subtotal esophagectomy for thoracic esophageal cancer (2002.1–2012.12). The overall survival was 82.5/83.5/52.1/50.0/32.1% for stage0/I/II/III/IVa (JES10th). The solitary cervical lymph node recurrence was diagnosed in 5 patients of Ivor-Lewis group, but 4 of the patient could be cured by additional cervical lymph node dissection. Conclusion Discussion: Intrathoracic anastomosis could minimize the risk of anastomotic leakage, and consequently the total complication rate could be reduced. The strategy that the cervical lymphadenectomy is performed only through the thoracic cavity in the selected patients was acceptable because of our survival data. Conclusion: Using our Ivor-Lewis procedure for the patients with thoracic esophageal cancer, even the open operation can minimize the risk of complication. Out therapeutic strategy could achieve satisfactory survival results. Disclosure All authors have declared no conflicts of interest.

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Begum, Shamim MF, Pupree Mutsuddy, and Sadia Sultana. "Lymphocele in a Renal Transplant Recipient During Lymphoscintigraphic Evaluation of Unilateral Leg Oedema: a Case Report." Bangladesh Journal of Nuclear Medicine 21, no. 1 (July 17, 2018): 43–45. http://dx.doi.org/10.3329/bjnm.v21i1.40271.

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Lymphocele is a common lymphatic complication in renal transplant recipient. The definition of lymphocele is a lymph-filled extraperitoneal space, with no epithelial lining. This condition may originate from leakage of lymph from unligated iliac vessels lymphatics of the recipient and/or surgical damage of the graft lymphatics during the procurement. The untreated complications may lead to catastrophic consequences. Early diagnosis and treatment of these complications are paramount to prevent graft failure and other significant morbidities to the patients. Here a case is presented in a haplotype renal transplant recipient showed abnormal radiotracer accumulation in the transplant fossa during lymphoscintigraphic evaluation with history of right lower limb swelling. Bangladesh J. Nuclear Med. 21(1): 43-45, January 2018

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Tomic, R., T. Granfors, J. G. Sjödin, and L. Öhberg. "Lymph Leakage After Staging Pelvic Lymphadenectomy for Prostatic Carcinoma with and Without Heparin Prophylaxis." Scandinavian Journal of Urology and Nephrology 28, no. 3 (September 1994): 273–75. http://dx.doi.org/10.3109/00365599409181277.

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Ida, Satoshi, Naoki Hiki, Takeaki Ishizawa, Yugo Kuriki, Mako Kamiya, Yasuteru Urano, Takuro Nakamura, et al. "Pancreatic Compression during Lymph Node Dissection in Laparoscopic Gastrectomy: Possible Cause of Pancreatic Leakage." Journal of Gastric Cancer 18, no. 2 (2018): 134. http://dx.doi.org/10.5230/jgc.2018.18.e15.

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Rössler, Jochen, Julia Geiger, Etelka Földi, Denise M. Adams, and Charlotte M. Niemeyer. "Sirolimus is highly effective for lymph leakage in microcystic lymphatic malformations with skin involvement." International Journal of Dermatology 56, no. 4 (October 5, 2016): e72-e75. http://dx.doi.org/10.1111/ijd.13419.

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Huang, Hai-Peng, Wen-Jun Xiong, Yao-Hui Peng, Yan-Sheng Zheng, Li-Jie Luo, Jin Li, Zi-Ming Cui, Xiao-Feng Zhu, Jin Wan, and Wei Wang. "Safety and Feasibility of No.12a Lymph Node Dissection by Portal Vein Approach in Radical Laparoscopic Gastrectomy for Gastric Cancer." Technology in Cancer Research & Treatment 19 (January 1, 2020): 153303382097127. http://dx.doi.org/10.1177/1533033820971277.

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Background: Traditional laparoscopic No.12a lymph node dissection in radical gastrectomy for gastric cancer may damage the peripheral blood vessels, and is not conducive to the full exposure of the portal vein and the root ligation of the left gastric vein. We recommend a new surgical procedure, the portal vein approach, to avoid these problems. Methods: 25 patients with advanced gastric cancer underwent radical laparoscopic gastrectomy and No.12a lymph node were dissected by portal vein approach, including 7 cases with total gastrectomy, 18 cases with distal gastric resection, 14 males and 11 females. Operative time, intraoperative blood loss, time to first flatus, postoperative hospital stay, number of total lymph node dissection and No.12a lymph node dissection, No.12a lymph node metastasis rate and postoperative complications were statistically observed. Results: All the patients were operated successfully and No.12a lymph node were cleaned by portal vein approach. A total of 683 lymph nodes were dissected, with the average number of lymph nodes dissection and positive lymph nodes were (27.3 ± 12.7) and (3.8 ± 5.6) respectively. The average number of No.12a lymph node dissection was (2.4 ± 1.95) and the metastasis rate of No.12a lymph node was 16% (4/25). The average operation time of radical laparoscopic distal and total gastrectomy were (239.2 ± 51.4) min and (295.1 ± 27.7) min respectively. The mean intraoperative blood loss was (134.0 ± 65.7) ml, and postoperative first anal exhaust time was (2.24 ± 0.86) d. The mean time to fluid intake was (4.2 ± 1.7) d, and postoperative hospitalization time was (9.6 ± 5.0) d. Without portal vein injure, anastomotic leakage, gastrointestinal bleeding, intestinal obstruction and other complications were observed in all patient. Conclusion: Our results show that the laparoscopic No.12a lymph node dissection by portal vein approach for gastric cancer is safe, feasible and has certain clinical application value.

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Goulart, André, Nuno Malheiro, Hugo Rios, Nuno Sousa, and Pedro Leão. "Influence of Visceral Fat in the Outcomes of Colorectal Cancer." Digestive Surgery 36, no. 1 (March 22, 2018): 33–40. http://dx.doi.org/10.1159/000486143.

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Aim: To determine the relationship of visceral fat (VF) with the surgical outcome of the patients with colorectal cancer (CRC) submitted to curative surgery. Methods: Retrospective analysis of all patients submitted to CRC surgery during 3 years with a minimum of 5 years of follow-up. We assessed the length of hospital stay, complications, pathologic reports, surgical re-interventions and hospital re-admissions, relapses, survival time and disease-free time. VF was calculated based on patients’ pre-operative CT-scan. The patients were divided into quartiles according to the VF area. Linear regression models and logistic regression models were used to establish a relationship between VF and all data collected. Results: The study included 199 patients (129 with colon cancer [CC] and 70 with rectal cancer). The average area of VF was 115.7 cm2. Patients with CRC revealed a direct relationship between VF and postoperative complications (p = 0.043), anastomotic leakage (p = 0.009) and re-operation (p = 0.005). The subgroup of patients with CC had an inverse association between VF and lymph nodes harvested (p = 0.027). Survival analyses did not reveal significant differences. Conclusion: VF has an influence on postoperative complications, anastomotic leakage and re-operation. A negative influence of VF on lymph nodes harvested was observed on CC patients.

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Akagi, Tomonori, Takao Hara, Masafumi Inomata, Junki Mizusawa, Hiroshi Katayama, Dai Shida, Masayuki Ohue, et al. "Clinical impact of D3 lymph node dissection preserving left colic artery (LCA) compared to D3 without preserving LCA: Exploratory subgroup analysis of data from randomized controlled trial of laparoscopic versus open surgery for colon cancer from Japan Clinical Oncology Group study JCOG0404." Journal of Clinical Oncology 37, no. 4_suppl (February 1, 2019): 653. http://dx.doi.org/10.1200/jco.2019.37.4_suppl.653.

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653 Background: In curative resection of sigmoid colon and rectal cancer, it is unclear whether D3 lymph node dissection preserving left colic artery (LCA) (Group A) is beneficial compared to D3 without preserving LCA (Group B) in terms of clinical outcomes. Preservation of LCA is expected to maintain blood supply which results in preventing anastomotic leakage, intestinal paralysis, and so on. Methods: The data of JCOG0404 (which is a randomized controlled trial comparing open to laparoscopic surgery for stage II/III colon cancer) were used. Eligibility criteria in JCOG0404 included histologically proven colon cancer; T3 or deeper lesion without involvement of other organs; N0-2 and M0. D3 lymph node dissection with or without preserving LCA was identified according to the photographs of the resected field collected for central surgical review in JCOG0404. The short and long-term outcomes were compared between each procedure. Results: Among all randomized 1057 patients in JCOG0404, 631 patients who received assigned sigmoid colectomy and anterior resection were included in the subgroup analysis. The number of patients were 135 in Group A and 496 in Group B. The patient backgrounds did not differ between groups. The median operative time, median blood loss, and the proportion of grade 1 or more anastomotic leakage and intestinal paralysis were not remarkably different (Group A vs. Group B: 185 min vs 186 min, 60 ml vs. 50 ml, 3.0% vs. 5.0%, and 2.2% vs. 3.8%). However, overall postoperative complication occurred more in Group B than in Group A (9.6% and 21.6%, p = 0.022). In terms of efficacy, 5-year relapse-free survival (RFS) and overall survival (OS) tended to be better in Group A than Group B (RFS: 83.7% and 80.5%, HR 1.25 (95% CI 0.79-1.96), OS: 96.3% and 91.1%, HR 2.47 (95% CI 1.13-5.40)). Conclusions: Short and long-term outcomes were better in Group A than Group B. It was considered that D3 lymph node dissection preserving LCA could be alternative treatment for D3 lymph node dissection. Clinical trial information: C000000105.

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Haraguchi, Masashi, Tamotsu Kuroki, Noritsugu Tsuneoka, Junichiro Furui, and Takashi Kanematsu. "Management of chylous leakage after axillary lymph node dissection in a patient undergoing breast surgery." Breast 15, no. 5 (October 2006): 677–79. http://dx.doi.org/10.1016/j.breast.2005.11.004.

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Kinugasa, Shoichi, Hiroshi Yoshimura, Dipok Kumar Dhar, Shuhei Ueda, Toshiyuki Fujii, Hitoshi Kohno, Naofumi Nagasue, and Mitsuo Tachibana. "Does Fibrin Glue Reduce Lymph Leakage (Pleural Effusion) after Extended Esophagectomy? Prospective Randomized Clinical Trial." World Journal of Surgery 27, no. 7 (July 1, 2003): 776–81. http://dx.doi.org/10.1007/s00268-003-6989-5.

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Park, Inhye, Nayoon Her, Jun-Ho Choe, Jee Soo Kim, and Jung-Han Kim. "Management of chyle leakage after thyroidectomy, cervical lymph node dissection, in patients with thyroid cancer." Head & Neck 40, no. 1 (November 9, 2017): 7–15. http://dx.doi.org/10.1002/hed.24852.

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Sprenger, Thilo, Tim Beissbarth, Rainer Fietkau, Hans-Rudolf Raab, Werner Hohenberger, Torsten Liersch, Claus Rödel, and Michael Ghadimi. "The prognostic impact of surgical complications after combined modality treatment of rectal cancer: Long-term results of the CAO/ARO/AIO-94 trial." Journal of Clinical Oncology 35, no. 4_suppl (February 1, 2017): 670. http://dx.doi.org/10.1200/jco.2017.35.4_suppl.670.

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670 Background: The influence of major surgical complications on survival in patients with locally advanced rectal cancer undergoing combined modality treatment is still debatable. The aim of this study was to evaluate the impact of surgical complications on oncological outcome in 823 patients with locally advanced rectal cancer treated within the phase III CAO/ARO/AIO-94 trial. Methods: Anastomotic leakages as well as wound healing disorders were prospectively evaluated and correlated with overall survival (OS) and the cumulative incidence of distant metastasis and local recurrence after a long-term follow-up of more than 10 years. Results: Anastomotic leakage after restorative rectal resection is significantly correlated with an impaired 10-year OS (51.0% vs. 65.2%, p = 0.02). Patients with abdominal or sacral wound healing disorders had a significantly reduced OS compared to those with sufficient wound healing (45.2% vs. 62.7%, p = 0.009). Patients developing any surgical complication (anastomotic leakage or/and wound healing disorder) had an impaired OS (50.6% vs 65.3%, p = 0.0002) as well as higher rates of distant metastases (65.3% vs. 72.7%, p = 0.03) and local recurrences (6.0% vs. 12.9%, p = 0.0007). In a multivariate cox regression model the only independent factors for restricted OS were lymph node metastases (p < 0.0001) and the occurrence of surgical complications (p = 0.008). Conclusions: Surgical complications are significantly associated with an adverse oncological outcome and reduced long-term OS in patients undergoing combined modality treatment for locally advanced rectal cancer.

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Kiudelis, Mindaugas, Jonas Bernotas, Antanas Mickevičius, Žilvinas Endzinas, and Almantas Maleckas. "Risk factors of esophagojejunal anastomosis leakage after total gastrectomy." Lietuvos chirurgija 12, no. 1-2 (January 1, 2013): 0. http://dx.doi.org/10.15388/lietchirur.2013.1-2.1571.

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Background/AimEsophagojejunal anastomotic leakage (EJAL) after total gastrectomy is one of the most frequent life-threatening complications. The rate of EJAL after total gastrectomy is about 2–11% worlwide. The aim of this study was to identify the independent prognostic risk factors that may predict EJAL progression for patients after total gastrectomy.Materials and methodsThis retrospective study analyzed medical records of 175 patients. All these patients had underwent radical gastrectomy due to gastric cancer. The analyzed factors were: age, gender, American Society of Anaesthesiologists (ASA) funtional class, splenectomy, anastomosis technique, operative time, cancer stage, the number of dissected lymph nodes, the number of metastatic lymph nodes, resection margins. White blood cells count, C reactive protein (CRP) value, body temperature, drain output were calculated in the early postoperative period.ResultsThe average age of the patients was 63.2 ± 11.5 years. The EJAL rate was found to be 6.3%. The mortality rate among patients who developed EJAL was 9%. Postoperative laboratory and clinical findings significantly related to EJAL were the average temperature of 4 postoperative days >37.2 oC (p = 0.018), postoperative white blood cell count >16.7 x 109/l (p = 0.031), postoperative CRP level >160 mg/l (p = 0.001) and operative time >248 min (p = 0.009), although the binary logistic regression analysis revealed that none of these variables can be used as statisticaly significant predictors for EJAL.ConclusionsThe esofagojejunal anastomotic leakage rate of 6.3% was found among patients undergoing radical gastrectomy due to gastric carcinoma. Mortality rate in case of EJAL increases up to 9%. In our study, we didn’t find any independent predictors for EJAL.Key words: gastrectomy, esophagojejunal anastomosis leakage, risk factorsEzofagojejuninės jungties nesandarumo išsivystymo rizikos veiksniai po gastrektomijosĮvadasEzofagojejuninės jungties nesandarumas (EJJN) po gastrektomijos yra viena iš didžiausią grėsmę gyvybei keliančių komplikacijų. Mokslinių tyrimų duomenimis, EJJN dažnis svyruoja nuo 2 iki 11 %. Darbo tikslas – nustatyti rizikos veiksnius,darančius įtaką ezofagojejuninės jungties nesandarumo vystymuisi po gastrektomijos dėl skrandžio vėžio, ir prognozuoti jų įtaką EJJN išsivystymui.Ligoniai ir metodaiRetrospektyviai ištirta 175 pacientų medicininė dokumentacija. Tirtiems pacientams 2006–2010 metais atlikta gastrektomija dėl skrandžio vėžio. Analizuoti veiksniai: amžius, lytis, Amerikos anesteziologų asociacijos (ASA) funkcinė klasė, splenektomija, jungties susiuvimo būdas, operacijos trukmė, naviko stadija, operacijos metu pašalintų limfmazgių skaičius, limfmazgių su mestazėmis skaičius, rezekciniai kraštai. Ankstyvuoju pooperaciniu laikotarpiu vertinta leukocitų kiekis, C reaktyviojo baltymo (CRB) koncentracija kraujyje, pooperacinė temperatūra, sekrecija pro drenus.RezultataiTirtų pacientų amžiaus vidurkis 63,2±11,5 metų. Vyrų 50,6 %, moterų 49,4 %. EJJN dažnis 6,3 %. Turėjusių EJJN pacientų mirtingumas siekė 9 %. Nustatyti rizikos veiksniai, statistiškai patikimai susiję su EJJN išsivystymu. Jų reikšmės patikslintosrandant ROC kreivės lūžio taškus: 4 parų vidutinė temperatūra 37,15oC (p=0,018), maksimalios leukocitų (11,7x109/l, p=0,031) ir C reaktyviojo baltymo reikšmės (159,95 mg/l, p=0,001), operacijos trukmė 247,5 min (p=0,009). Tačiau binarinė logistinė regresija parodė, kad šie kriterijai negali būti statistiškai patikimi prognoziniai EJJN vystymosi veiksniai.IšvadosEzofagojejuninės jungties nesandarumo dažnis po gastrektomijos dėl skrandžio vėžio yra 6,3%, šią komplikaciją turėjusių pacientų mirštamumas – 9%. Savo tyrime neradome prognostiškai reikšmingų rizikos veiksnių.Reikšminiai žodžiai: gastrektomija, ezofagojejuninės jungties nesandarumas, rizikos veiksniai

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43

Kiudelis, Mindaugas, Jonas Bernotas, Antanas Mickevičius, Žilvinas Endzinas, and Almantas Maleckas. "Risk factors of esophagojejunal anastomosis leakage after total gastrectomy." Lietuvos chirurgija 12, no. 1-2 (January 1, 2013): 0. http://dx.doi.org/10.15388/lietchirur.2013.1.1571.

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Background/AimEsophagojejunal anastomotic leakage (EJAL) after total gastrectomy is one of the most frequent life-threatening complications. The rate of EJAL after total gastrectomy is about 2–11% worlwide. The aim of this study was to identify the independent prognostic risk factors that may predict EJAL progression for patients after total gastrectomy.Materials and methodsThis retrospective study analyzed medical records of 175 patients. All these patients had underwent radical gastrectomy due to gastric cancer. The analyzed factors were: age, gender, American Society of Anaesthesiologists (ASA) funtional class, splenectomy, anastomosis technique, operative time, cancer stage, the number of dissected lymph nodes, the number of metastatic lymph nodes, resection margins. White blood cells count, C reactive protein (CRP) value, body temperature, drain output were calculated in the early postoperative period.ResultsThe average age of the patients was 63.2 ± 11.5 years. The EJAL rate was found to be 6.3%. The mortality rate among patients who developed EJAL was 9%. Postoperative laboratory and clinical findings significantly related to EJAL were the average temperature of 4 postoperative days >37.2 oC (p = 0.018), postoperative white blood cell count >16.7 x 109/l (p = 0.031), postoperative CRP level >160 mg/l (p = 0.001) and operative time >248 min (p = 0.009), although the binary logistic regression analysis revealed that none of these variables can be used as statisticaly significant predictors for EJAL.ConclusionsThe esofagojejunal anastomotic leakage rate of 6.3% was found among patients undergoing radical gastrectomy due to gastric carcinoma. Mortality rate in case of EJAL increases up to 9%. In our study, we didn’t find any independent predictors for EJAL.Key words: gastrectomy, esophagojejunal anastomosis leakage, risk factorsEzofagojejuninės jungties nesandarumo išsivystymo rizikos veiksniai po gastrektomijosĮvadasEzofagojejuninės jungties nesandarumas (EJJN) po gastrektomijos yra viena iš didžiausią grėsmę gyvybei keliančių komplikacijų. Mokslinių tyrimų duomenimis, EJJN dažnis svyruoja nuo 2 iki 11 %. Darbo tikslas – nustatyti rizikos veiksnius,darančius įtaką ezofagojejuninės jungties nesandarumo vystymuisi po gastrektomijos dėl skrandžio vėžio, ir prognozuoti jų įtaką EJJN išsivystymui.Ligoniai ir metodaiRetrospektyviai ištirta 175 pacientų medicininė dokumentacija. Tirtiems pacientams 2006–2010 metais atlikta gastrektomija dėl skrandžio vėžio. Analizuoti veiksniai: amžius, lytis, Amerikos anesteziologų asociacijos (ASA) funkcinė klasė, splenektomija, jungties susiuvimo būdas, operacijos trukmė, naviko stadija, operacijos metu pašalintų limfmazgių skaičius, limfmazgių su mestazėmis skaičius, rezekciniai kraštai. Ankstyvuoju pooperaciniu laikotarpiu vertinta leukocitų kiekis, C reaktyviojo baltymo (CRB) koncentracija kraujyje, pooperacinė temperatūra, sekrecija pro drenus.RezultataiTirtų pacientų amžiaus vidurkis 63,2±11,5 metų. Vyrų 50,6 %, moterų 49,4 %. EJJN dažnis 6,3 %. Turėjusių EJJN pacientų mirtingumas siekė 9 %. Nustatyti rizikos veiksniai, statistiškai patikimai susiję su EJJN išsivystymu. Jų reikšmės patikslintosrandant ROC kreivės lūžio taškus: 4 parų vidutinė temperatūra 37,15oC (p=0,018), maksimalios leukocitų (11,7x109/l, p=0,031) ir C reaktyviojo baltymo reikšmės (159,95 mg/l, p=0,001), operacijos trukmė 247,5 min (p=0,009). Tačiau binarinė logistinė regresija parodė, kad šie kriterijai negali būti statistiškai patikimi prognoziniai EJJN vystymosi veiksniai.IšvadosEzofagojejuninės jungties nesandarumo dažnis po gastrektomijos dėl skrandžio vėžio yra 6,3%, šią komplikaciją turėjusių pacientų mirštamumas – 9%. Savo tyrime neradome prognostiškai reikšmingų rizikos veiksnių.Reikšminiai žodžiai: gastrektomija, ezofagojejuninės jungties nesandarumas, rizikos veiksniai

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Huang, Yu-Han, Ke-Cheng Chen, Sian-Han Lin, Pei-Ming Huang, Pei-Wen Yang, and Jang-Ming Lee. "Robotic-assisted single-incision gastric mobilization for minimally invasive oesophagectomy for oesophageal cancer: preliminary results." European Journal of Cardio-Thoracic Surgery 58, Supplement_1 (July 2, 2020): i65—i69. http://dx.doi.org/10.1093/ejcts/ezaa212.

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Abstract OBJECTIVES With the gradual acceptance of robotic-assisted surgery to treat oesophageal cancer and the application of a single-port approach in several abdominal procedures, we adopted a single-port technique in robotic-assisted minimally invasive oesophagectomy during the abdominal phase for gastric mobilization and abdominal lymph node dissection. METHODS Robotic-assisted oesophagectomy and mediastinal lymph node dissection in the chest were followed by robotic-assisted gastric mobilization and conduit creation with abdominal lymph node dissection, which were performed via a periumbilicus single incision. The oesophagogastrostomy was accomplished either in the chest (Ivor Lewis procedure) or neck (McKeown procedure) depending on the status of the proximal resection margin. RESULTS The procedure was successfully performed on 11 patients with oesophageal cancer from January 2017 to December 2018 in our institute. No surgical or in-hospital deaths occurred, though we had one case each of anastomotic leakage, pneumonia and hiatal hernia (9%). CONCLUSIONS Robotic single-incision gastric mobilization for minimally invasive oesophagectomy for treating oesophageal cancer seems feasible. Its value in terms of perioperative outcome and long-term survival results awaits future evaluation.

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Tolmane, Ieva, Baiba Rozentāle, Jāzeps Keišs, and Viesturs Putniņš. "Liver Damage after Breast Plastic Surgery - Clinical Case Report." Acta Chirurgica Latviensis 11, no. 1 (January 1, 2011): 159–60. http://dx.doi.org/10.2478/v10163-012-0033-5.

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Liver Damage after Breast Plastic Surgery - Clinical Case Report Since silicone implants were introduced in the early 1960s, those have been widely used for cosmetic and reconstructive breast surgery. Although a recent review has shown no relationship between the silicone breast implant and systemic complications, leakage of the silicone into the tissues and migration to the regional lymph nodes remains a clinical problem. This was the first case in our practice when possibly breast implant material was found in the liver tissue.

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Sato, Hiroshi, Yutaka Miyawaki, Masayasu Aikawa, Kojun Okamoto, Shinichi Sakuramoto, Shigeki Yamaguchi, and Isamu Koyama. "PS02.013: THORACOSCOPIC ESOPHAGECTOMY WITH RADICAL LYMPH NODE DISSECTION FOR THORACIC ESOPHAGEAL CARCINOMA IN THE LEFT LATERAL DECUBITUS POSITION." Diseases of the Esophagus 31, Supplement_1 (September 1, 2018): 124. http://dx.doi.org/10.1093/dote/doy089.ps02.013.

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Abstract Background The rates of thoracoscopic esophagectomy performed in the prone and left lateral decubitus positions are similar in Japan. We retrospectively reviewed short term outcomes of thoracoscopic esophagectomy for esophageal cancer performed in the left lateral decubitus position under artificial pneumothorax by CO2 insufflation in a single institution. This study aimed to evaluate the feasibility of applying this procedure. Methods Between July 2013 and March 2017, 83 patients with esophageal cancer underwent thoracoscopic esophagectomy in the left lateral decubitus position under artificial pneumothorax by CO2 insufflation. The thoracic procedure is performed as follows: The lymph nodes around the right recurrent laryngeal nerve are dissected. On the cranial side, the lymph node dissection is advanced to the level of the inferior thyroid artery. Then, the assistant rotates the trachea toward the ventral side, and the lymph nodes around the left recurrent laryngeal nerve are dissected. The middle and inferior mediastinal lymph nodes are dissected including supradiaphragmatic lymph nodes and the dorsal lymph nodes around the thoracic descending aorta. Then, the esophagus is transected using an automatic suture device. Finally, the tracheal bifurcation area lymph nodes are dissected. We retrospectively analyzed these patients. Results The completion rate of thoracoscopic esophagectomy was 94.0%, and the procedure was converted to thoracotomy in five patients, due to hemorrhage, severe adhesion. The mean intrathoracic operative time, intrathoracic blood loss, and number of dissected mediastinal lymph nodes were 220.0 min, 130.1 mL, and 22.0, respectively. Postoperative complications included pneumonia (8.4%), anastomotic leakage (16.9%), and recurrent nerve paralysis (8.4%). Postoperative (30d) mortality was 1/83 (1.2%) due to ARDS. Conclusion Standardization of the procedure for thoracoscopic esophagectomy in the left lateral decubitus position under artificial pneumothorax by CO2 insufflation, with a standardized clinical pathway for perioperative care led to favorable surgical outcomes. Disclosure All authors have declared no conflicts of interest.

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Ciudad, Pedro, Joseph M. Escandón, Oscar J. Manrique, and Valeria P. Bustos. "Lessons Learnt from an 11-year Experience with Lymphatic Surgery and a Systematic Review of Reported Complications: Technical Considerations to Reduce Morbidity." Archives of Plastic Surgery 49, no. 02 (March 2022): 227–39. http://dx.doi.org/10.1055/s-0042-1744412.

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AbstractComplications experienced during lymphatic surgery have not been ubiquitously reported, and little has been described regarding how to prevent them. We present a review of complications reported during the surgical management of lymphedema and our experience with technical considerations to reduce morbidity from lymphatic surgery. A comprehensive search across different databases was conducted through November 2020. Based on the complications identified, we discussed the best approach for reducing the incidence of complications during lymphatic surgery based on our experience. The most common complications reported following lymphovenous anastomosis were re-exploration of the anastomosis, venous reflux, and surgical site infection. The most common complications using groin vascularized lymph node transfer (VLNT), submental VLNT, lateral thoracic VLNT, and supraclavicular VLNT included delayed wound healing, seroma and hematoma formation, lymphatic fluid leakage, iatrogenic lymphedema, soft-tissue infection, venous congestion, marginal nerve pseudoparalysis, and partial flap loss. Regarding intra-abdominal lymph node flaps, incisional hernia, hematoma, lymphatic fluid leakage, and postoperative ileus were commonly reported. Following suction-assisted lipectomy, significant blood loss and transient paresthesia were frequently reported. The reported complications of excisional procedures included soft-tissue infections, seroma and hematoma formation, skin-graft loss, significant blood loss, and minor skin flap necrosis. Evidently, lymphedema continues to represent a challenging condition; however, thorough patient selection, compliance with physiotherapy, and an experienced surgeon with adequate understanding of the lymphatic system can help maximize the safety of lymphatic surgery.

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Baek, Jong Min, Jin A. Lee, Yu Hee Nam, Gi Young Sung, Do Sang Lee, and Jong Man Won. "Chylous Leakage: A Rare Complication after Axillary Lymph Node Dissection in Breast Cancer and Surgical Management." Journal of Breast Cancer 15, no. 1 (2012): 133. http://dx.doi.org/10.4048/jbc.2012.15.1.133.

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Seong, Ik Hyun, Jin-Woo Park, and Kyong-Je Woo. "No-fat diet for treatment of donor site chyle leakage in vascularized supraclavicular lymph node transfer." Archives of Craniofacial Surgery 21, no. 6 (December 20, 2020): 376–79. http://dx.doi.org/10.7181/acfs.2020.00437.

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Konishi, Ikuo, Shingo Fujii, Yoshihiko Nanbu, Hirofumi Nonogaki, and Takahide Mori. "Mucin leakage into the cervical stroma may increase lymph node metastastsis in mucin-producing cervical adenocarcinomas." Cancer 65, no. 2 (January 15, 1990): 229–37. http://dx.doi.org/10.1002/1097-0142(19900115)65:2<229::aid-cncr2820650209>3.0.co;2-g.

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Journal articles on the topic 'Lymph leakage'

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