Abdominal lymphocele following multi-level anterior lumbar interbody fusion (ALIF) managed with a laparoscopic peritoneal window: case report and review of the literature,European Spine Journal

当前位置： X-MOL 学术 › Eur. Spine J. › 论文详情

Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)

Abdominal lymphocele following multi-level anterior lumbar interbody fusion (ALIF) managed with a laparoscopic peritoneal window: case report and review of the literature
European Spine Journal ( IF 2.6 ) Pub Date : 2023-12-26 , DOI: 10.1007/s00586-023-08072-x
Andrew P Collins ₁ , Christopher E Freise ₂ , Jade Hiramoto ₃ , Aaron J Clark ₄ , Alekos A Theologis ₅

Affiliation

Purpose

Lymphocele formation following anterior lumbar interbody fusion (ALIF) is not common, but it can pose diagnostic and treatment challenges. The purpose of this case is to report for the first time the treatment of a postoperative lymphocele following a multi-level ALIF using a peritoneal window made through a minimally invasive laparoscopic approach.

Methods

Case report.

Results

A 74-year-old male with a history of prostatectomy and pelvic radiation underwent a staged L3–S1 ALIF (left paramedian approach) and T10-pelvis posterior instrumented with L1–5 decompression/posterior column osteotomies for degenerative scoliosis and neurogenic claudication. Three weeks after surgery, swelling of the left abdomen and entire left leg was reported. Computed tomography of the abdomen/pelvis demonstrated a large (19.2 × 12.0 × 15.4 cm) retroperitoneal fluid collection with compression of the left ureter and left common iliac vein. Fluid analysis (80% lymphocytes) was consistent with a lymphocele. Percutaneous drainage for 4 days was ineffective at clearing the lymphocele. For more definitive management, the patient underwent an uncomplicated laparoscopic creation of a peritoneal window to allow passive drainage of lymphatic fluid into the abdomen. Three years after surgery, he had no back or leg pain, had achieved spinal union, and had no abdominal swelling or left leg swelling. Advanced imaging also confirmed resolution of the lymphocele.

Conclusions

In this case report, creation of a peritoneal window minimally invasively via a laparoscope allowing passive drainage of lymphatic fluid into the abdomen was safe and effective for management of an abdominal lymphocele following a multi-level ALIF.

中文翻译：

腹腔镜腹膜窗多节段前路腰椎间融合术（ALIF）后腹部淋巴囊肿：病例报告和文献综述

目的

前路腰椎椎间融合 (ALIF) 后形成淋巴囊肿并不常见，但它可能会给诊断和治疗带来挑战。本病例的目的是首次报告使用通过微创腹腔镜方法制作的腹膜窗治疗多级 ALIF 术后淋巴囊肿。

方法

病例报告。

结果

一名 74 岁男性，有前列腺切除术和骨盆放射史，接受分期 L3-S1 ALIF（左旁正中入路）和 T10 骨盆后部器械，并进行 L1-5 减压/后柱截骨术，治疗退行性脊柱侧凸和神经源性跛行。手术三周后，据报道左腹部和整个左腿肿胀。腹部/骨盆计算机断层扫描显示大量（19.2 × 12.0 × 15.4 cm）腹膜后积液，左输尿管和左髂总静脉受压。体液分析（80% 淋巴细胞）与淋巴细胞肿大一致。经皮引流4天对于清除淋巴囊肿无效。为了进行更明确的治疗，患者接受了简单的腹腔镜手术，创建腹膜窗，以便将淋巴液被动引流到腹部。手术后三年，他没有背部或腿部疼痛，脊柱已愈合，腹部也没有肿胀，左腿也没有肿胀。先进的成像也证实了淋巴囊肿的消退。