Dokument: Percutaneous fractionated radiotherapy of the groin to eliminate lymphatic fistulas after vascular surgery

Titel:Percutaneous fractionated radiotherapy of the groin to eliminate lymphatic fistulas after vascular surgery
URL für Lesezeichen:https://docserv.uni-duesseldorf.de/servlets/DocumentServlet?id=67380
URN (NBN):urn:nbn:de:hbz:061-20241107-094023-5
Kollektion:Publikationen
Sprache:Englisch
Dokumententyp:Wissenschaftliche Texte » Artikel, Aufsatz
Medientyp:Text
Autoren: Jazmati, Danny [Autor]
Tamaskovics, Bálint [Autor]
Hoff, Norman-Philipp [Autor]
Homey, Bernhard [Autor]
Bölke, Edwin [Autor]
Belebenie Boyomo, Armand [Autor]
Garabet, Waseem [Autor]
Haussmann, Jan [Autor]
Budach, Wilfried [Autor]
Neuwahl, Judith [Autor]
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Dateien vom 07.11.2024 / geändert 07.11.2024
Stichwörter:Surgery, Benign disease, Side effects, Radiation therapy, Wound healing, Amputation
Beschreibung:Background

Vascular surgery of the inguinal area can be complicated by persistent lymphatic fistulas. Rapid and effective treatment is essential to prevent infection, sepsis, bleeding, and possible leg amputation. Current data on irradiation of lymphatic fistulas lack recommendation on the appropriate individual and total dose, the time of irradiation, and the target volume. Presumably, a dose of 0.3–0.5 to 1–12 Gy should be sufficient for the purpose. Currently, radiotherapy is a “can” recommendation, with a level 4 low evidence and a grade C recommendation, according to the DEGRO S2 guidelines. As part of a pilot study, we analyzed the impact and limitations of low-dose radiation therapy in the treatment of inguinal lymphatic fistulas.
Patients and methods

As a part of an internal quality control project, patients with lymphatic fistulas irradiated in the groin area after vascular surgery for arterial occlusive disease (AOD) III-IV, repair of pseudo aneurysm or lymph node dissection due to melanoma were selected, and an exploratory analysis on retrospectively collected data performed.
Results

Twelve patients (10 males and 2 females) aged 62.83 ± 12.14 years underwent open vascular reconstruction for stage II (n = 2), III (n = 1), and IV (n = 7) arterial occlusive disease (AOD), lymph node dissection for melanoma (n = 1) or repair of a pseudoaneurysm (n = 1). Surgical vascular access was obtained through the groin and was associated with a persistent lymphatic fistula, secreting more than 50 ml/day. Patients were irradiated five times a week up to a maximum of 10 fractions for the duration of the radiation period. Fraction of 0.4 Gy was applied in the first 7 cases, while 5 patients were treated with a de-escalating dose of 0.3 Gy. There was a resolution of the lymphatic fistula in every patient without higher grade complications.
Conclusion

Low-dose irradiation of the groin is a treatment option for persistent lymphatic fistula after inguinal vascular surgery.
Rechtliche Vermerke:Originalveröffentlichung:
Jazmati, D., Tamaskovics, B., Hoff, N.-P., Homey, B., Bölke, E., Belebenie Boyomo, A., Garabet, W., Haussmann, J., Budach, W., Neuwahl, J., Schelzig, H., Corradini, S., van Griensven, M., Fischer, J., Knoefel, W. T., Pegani, J., Pedoto, A., Antoch, G., Kirchner, J. P., … Matuschek, C. (2023). Percutaneous fractionated radiotherapy of the groin to eliminate lymphatic fistulas after vascular surgery [OnlineRessource]. European Journal of Medical Research, 28, Article 70. https://doi.org/10.1186/s40001-023-01033-6
Lizenz:Creative Commons Lizenzvertrag
Dieses Werk ist lizenziert unter einer Creative Commons Namensnennung 4.0 International Lizenz
Fachbereich / Einrichtung:Medizinische Fakultät
Dokument erstellt am:07.11.2024
Dateien geändert am:07.11.2024
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