Radiotherapy of inguinal lymphorrhea after vascular surgery. A retrospective analysis

Background and purpose: the formation of inguinal lymphorrhea following vascular surgery is a rare but potentially serious problem with an incidence of about 2%. There is no consensus on the most effective treatment for groin lymphorrhea. In a retrospective analysis the usefulness of irradiation in the treatment of inguinal lymph fistulas was investigated. Patients and methods: from 08/1997 to 12/2000, 28 patients with inguinal lymph fistulas were irradiated postoperatively (4th-19th day) with a single dose of 3 Gy up to a total dose of 9 Gy on 3 consecutive days using 120- to 300-kV photons. Three further patients received 2 x 4 Gy and 3 x 5 Gy, respectively, due to an interposed weekend. Results: secretion volume at the beginning of radiotherapy varied between 50 and 650 ml daily (mean 203 ml, median 175 ml), at the end of radiotherapy between 0 and 350 ml (mean 126 ml, median 120 ml). 3/28 lymph fistulas had resolved during radiotherapy. In 17/28 patients (60.7%) the drains could be removed within 10 days, in further 10/28 patients (35.7%) within 10-20 days after the end of radiotherapy. Conclusion: overall, irradiation of inguinal lymph fistulas proved to be an effective and well-tolerated treatment, facilitating removal of fistula drains within 10-20 days (mean 10.5, median 7 days) after the completion of radiotherapy, thus appearing a good alternative to other conservative treatment modalities. (orig.)