Experience of a Combination of Lymphatic Embolization and Transcutaneous Sclerotherapy for Intractable Inguinal Lymphorrhea

Abstract

Lymphorrhea occasionally occurs as a complication of surgical manipulation and is often difficult to treat. This report describes two cases of inguinal lymphorrhea diagnosed after lymph node biopsy and arterial puncture and treated with lymph embolization and transcutaneous sclerotherapy using OK-432.
In both cases, intranodal lymphatic embolization was performed with n-butyl-2-cyanoacrylate after lymphangiography of the lymph nodes around the wound, followed by debridement, sclerotherapy with OK-432, and wound closure.
No recurrence of lymphorrhea was observed.
Conservative treatment for lymphorrhea comprises compression, fat restriction, and negative-pressure wound therapy, including identification and ligation of the lymphatic vessels, closure with a musculocutaneous flap, lymphaticovenular and lymphaticolymphatic anastomosis. The combination of intranodal lymphatic embolization, sclerotherapy with OK-432, and wound closure performed in this study is a minimally invasive method that can achieve wound closure in a short period.

Sclerotherapy with OK-432 and closed wound.

(a) Intraoperative design. (b) After debridement. (c) OK-432 injection in progress. (d) Immediately after the operation. The release wound was debrided under local anesthesia, and the wound OK-432:5KE was injected into the wound. A continuous suction drain was placed, and the wound was sutured closed.