TY - JOUR
T1 - Treatment of symptomatic postoperative pelvic lymphoceles
T2 - A systematic review
AU - ten Hove, Anne S.
AU - Tjiong, Ming Y.
AU - Zijlstra, Ijsbrand A.J.
PY - 2021/1
Y1 - 2021/1
N2 - Purpose: A broad range of therapeutic options exists for symptomatic postoperative lymphoceles. However, no consensus exists on what is the optimal therapy. In this study, we aimed to compare the efficacy of currently available radiologic interventions in terms of number of successful interventions, number of recurrences, and number of complications. Methods: A systematic review was conducted with a pre-defined search strategy for PubMed, EMBASE, and Cochrane databases from inception until September 2019. Quality assessment was performed using the ‘Risk Of Bias In Non-randomized Studies - of Interventions’ tool. Statistical heterogeneity was assessed using the I2 and χ2 test and a meta-analysis was considered for studies reporting on multiple interventions. Results: 37 eligible studies including 732 lymphoceles were identified. Proportions of successful interventions for percutaneous fine needle aspiration, percutaneous catheter drainage, percutaneous catheter drainage with delayed or instantaneous addition of sclerotherapy, and embolization were as follows: 0.341 (95% confidence interval [CI]: 0.185−0.542), 0.612 (95% CI: 0.490−0.722), 0.890 (95% CI: 0.781−0.948), 0.872 (95% CI: 0.710−0.949), 0.922 (95% CI: 0.731−0.981). Random-effects meta-analysis of seven studies revealed a pooled relative risk for percutaneous catheter drainage with delayed addition of sclerotherapy of 1.57 (95% CI: 1.17–2.10) when compared to percutaneous catheter drainage alone. The risk of bias in this study was severe. Conclusions: This systematic review demonstrates that the success rates of percutaneous catheter drainage with sclerotherapy are more favorable when compared to percutaneous catheter drainage alone in the treatment of postoperative pelvic lymphoceles. Overall, percutaneous catheter drainage with delayed addition of sclerotherapy, and embolization showed the best outcomes.
AB - Purpose: A broad range of therapeutic options exists for symptomatic postoperative lymphoceles. However, no consensus exists on what is the optimal therapy. In this study, we aimed to compare the efficacy of currently available radiologic interventions in terms of number of successful interventions, number of recurrences, and number of complications. Methods: A systematic review was conducted with a pre-defined search strategy for PubMed, EMBASE, and Cochrane databases from inception until September 2019. Quality assessment was performed using the ‘Risk Of Bias In Non-randomized Studies - of Interventions’ tool. Statistical heterogeneity was assessed using the I2 and χ2 test and a meta-analysis was considered for studies reporting on multiple interventions. Results: 37 eligible studies including 732 lymphoceles were identified. Proportions of successful interventions for percutaneous fine needle aspiration, percutaneous catheter drainage, percutaneous catheter drainage with delayed or instantaneous addition of sclerotherapy, and embolization were as follows: 0.341 (95% confidence interval [CI]: 0.185−0.542), 0.612 (95% CI: 0.490−0.722), 0.890 (95% CI: 0.781−0.948), 0.872 (95% CI: 0.710−0.949), 0.922 (95% CI: 0.731−0.981). Random-effects meta-analysis of seven studies revealed a pooled relative risk for percutaneous catheter drainage with delayed addition of sclerotherapy of 1.57 (95% CI: 1.17–2.10) when compared to percutaneous catheter drainage alone. The risk of bias in this study was severe. Conclusions: This systematic review demonstrates that the success rates of percutaneous catheter drainage with sclerotherapy are more favorable when compared to percutaneous catheter drainage alone in the treatment of postoperative pelvic lymphoceles. Overall, percutaneous catheter drainage with delayed addition of sclerotherapy, and embolization showed the best outcomes.
KW - Embolization
KW - Interventional radiology
KW - Lymphocele
KW - Percutaneous catheter drainage
KW - Percutaneous fine needle aspiration
KW - Sclerotherapy
UR - http://www.scopus.com/inward/record.url?scp=85097417698&partnerID=8YFLogxK
U2 - 10.1016/j.ejrad.2020.109459
DO - 10.1016/j.ejrad.2020.109459
M3 - Article
C2 - 33302026
AN - SCOPUS:85097417698
VL - 134
JO - European Journal of Radiology
JF - European Journal of Radiology
SN - 0720-048X
M1 - 109459
ER -