Mp22-10 Lymphatic Embolization for Post-Operative Lymphatic Leakage After Radical Cystectomy for Bladder Cancer

You have accessJournal of UrologyBladder Cancer: Invasive II (MP22)1 May 2024MP22-10 LYMPHATIC EMBOLIZATION FOR POST-OPERATIVE LYMPHATIC LEAKAGE AFTER RADICAL CYSTECTOMY FOR BLADDER CANCER Yoo Sub Shin, Jongsoo Lee, Hyun Ho Han, Won Sik Jang, and Ji Eun Heo Yoo Sub ShinYoo Sub Shin , Jongsoo LeeJongsoo Lee , Hyun Ho HanHyun Ho Han , Won Sik JangWon Sik Jang , and Ji Eun HeoJi Eun Heo View All Author Informationhttps://doi.org/10.1097/01.JU.0001008608.50694.4b.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Radical Cystectomy (RC) with pelvic lymph node dissection (PLND) is the standard treatment of muscle invasive bladder cancer. However, PLND commonly causes lymphatic leakage, which delays post-operative drainage catheter removal. Recent studies describe lymphatic embolization (LE) as an option to manage post operative lymphatic leakage. Hence, our study evaluated the outcome of LE for lymphatic leakage after RC and analyzed factors associated with outcomes. METHODS: We retrospectively reviewed medical records of patients who underwent LE after RC with PLND. Treatment indication was lymphatic drainage of >500 mL/d persisting for >1 week. Clinical failure of LE was defined as 1) persistent lymphatic drainage requiring re-embolization, 2) failure to remove drainage within 1 week of LE, 3) lymphatic complications after LE. Demographic and pathologic variables for predicting outcomes of LE were identified by logistic regression analysis. RESULTS: LE was performed in 47 patients and 41 patients were included in the study. Twenty-one (51.2%) patients were identified as clinically successful. The demographic characteristics did not differ between the two groups. Average drainage per day was 507.1 mL/d and 625.0 mL/d in the success and failure groups (p=0.068). The maximum amount of drainage per day of the failure group was significantly higher than that of the success group (749.2 mL/d vs. 1051.7 mL/d, p=0.025). Duration from operation to LE was not different between the two groups (8.05 d vs. 13.15 d, p=0.176). In 20 (48.8%) patients who showed clinical failure of LE, 4 patients required re-embolization, while 10 patients failed to remove their drain within 7 days of intervention. There were 8 cases of lymphatic complication after LE: 3 cases of lower extremity edema and 5 cases of lymphoceles. In logistic regression analysis, maximum drainage greater than 1000 mL/d (OR 3.911, 95% CI 1.028- 14.875, p=0.045) and absence of perineural invasion (OR 0.109, 95% CI 0.024-0.492, p=0.004) were associated with clinical failure for LE. This association persisted in multivariate analysis. CONCLUSIONS: LE is an effective procedure to manage lymphatic leakage after RC with PLND. Re-intervention may be required in some patients; lymphatic drainage of more than 1000 mL/d was associated with clinical failure of LE. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e345 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Yoo Sub Shin More articles by this author Jongsoo Lee More articles by this author Hyun Ho Han More articles by this author Won Sik Jang More articles by this author Ji Eun Heo More articles by this author Expand All Advertisement PDF downloadLoading ...