Ligation of lymph vessels for the treatment of recurrent inguinal lymphoceles following lymphadenectomy.

Background: Recurrent lymphocele following groin dissection is generally a self-limiting condition, but in a few cases, the lymphocele persists and for this, there are not many options. Few reports have proposed the efficacy of lymph vessel ligation with patent blue as a vessel locator. We have used this technique since 2007 in our very severe cases and herein present our results.

Methods: The study was a retrospective case series in a university hospital setting. All patients who had this procedure performed were included from the first procedure performed in 2007 until August 2015, and their data was retrieved from electronic patient records.

Results: In total, eight patients had this procedure performed for a total of ten inguinal regions. In all regions, leaking lymph vessels were easily found by the blue color and a median of 3 (range 1-5 vessels) vessels per region were ligated using titanium clips. For two patients, there was still a need for puncture which lasted 13-37 days postoperatively. For the remaining patients, there was an immediate stop in lymphocele formation but one patient developed a lymphatic malformation which after removal resulted in the recurrence of lymphocele and had the procedure performed again with immediate effect.

Conclusions: Ligation of lymph vessels for the treatment of recurrent inguinal lymphoceles appears to be an appropriate treatment modality that is both quick and easy to perform with minimum risk, and in most cases, it results in immediate complete stop in the lymphocele formation.