Purpose: To observe the feasibility and efficacy of Pseudomonas aeruginosa -mannose sensitive hemagglutinin (PA-MSHA) in refractory lymphatic leakage following lymphadenectomy among patients with gynecological cancers.
Patients and Methods: Ten cases with post-operative massive lymphatic leakage were collected, in which patients failed to respond to conservative treatment. Topical PA-MSHA injection of a single dose (2mL) was performed through drainage tube or transvaginal catheter into pelvic or peritoneal cavity. Drainage volumes and side effects were recorded.
Results: The incidence of refractory lymphatic leakage following pelvic and para-aortic lymphadenectomy was 2.44% (10/409). All ten patients (100%) had quick recovery and were discharged within 72 hours. Among them, one patient (10%) experienced fever and six patients (60%) experienced abdominal pain, one of which was moderate and relieved by routine analgesic treatment. During 11 (6– 38) months of follow-up time, no long-term side effect was observed.
Conclusion: Topical injection of PA-MSHA of a single dose appears a feasible and effective treatment for refractory post-operative lymphatic leakage.
Keywords: Pseudomonas aeruginosa -mannose sensitive hemagglutinin (PA-MSHA) injection, pelvic and para-aortic lymphadenectomy, lymphatic leakage, chylous leakage