Two Cases of Refractory Lymphorrhea Responsive to Negative Pressure Wound Therapy that Developed after Metastatic Lymph Node Resection of Colorectal Cancer

Abstract

Introduction : Lymphorrhea sometimes develops after lymph node dissection and can be intractable. Two cases of refractory lymphorrhea after metastatic lymph node resection of colorectal cancer that responded to negative pressure wound therapy are presented.

Presentation of case 1 : A 76-year-old man developed a recurrence of anal canal cancer in the left inguinal lymph nodes after local resection of the primary lesion. He underwent left inguinal lymph node dissection, and lymphorrhea occurred immediately after surgery. Lymphography and lymph node resection did not improve the lymphorrhea. Selective suture of the fistulas and negative pressure wound therapy improved the lymphorrhea nine days after the procedure.

Presentation of case 2 : An 87-year-old man developed a recurrence in the left inguinal lymph nodes after resection of multiple primary colon cancer in the cecum and ascending colon. He underwent left inguinal lymph node resection and developed lymphorrhea soon after surgery. The lymphorrhea was refractory to lymphography and lymphatic embolization ; the condition was not responsive to conservative therapy for a month. Negative pressure wound therapy improved the lymphorrhea 23 days after the procedure.

Conclusion : Negative pressure wound therapy may be helpful for treating superficial, refractory lymphorrhea.