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Abdominal lymphocele following multi-level anterior lumbar interbody fusion (ALIF) managed with a laparoscopic peritoneal window: case report and review of the literature – Lumbar Fusion

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The article discusses the case of a postoperative lymphocele following a multi-level anterior lumbar interbody fusion (ALIF) procedure and the treatment using a minimally invasive laparoscopic approach. A 74-year-old male experienced swelling in the abdomen and leg after the surgery, and a large retroperitoneal fluid collection was identified. Percutaneous drainage was ineffective, and therefore a laparoscopic creation of a peritoneal window was performed to allow passive drainage of the lymphatic fluid into the abdomen. Three years after the treatment, the patient had no pain, achieved spinal union, and the lymphocele resolved. The study concludes that the creation of a peritoneal window via laparoscopy was safe and effective in managing an abdominal lymphocele following a multi-level ALIF procedure

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most advanced spinal centre in London

Published article

S: In this case report, creation of a peritoneal window minimally invasively via a laparoscope allowing passive drainage of lymphatic fluid into the abdomen was safe and effective for management of an abdominal lymphocele following a multi-level ALIF.

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Eur Spine J. 2023 Dec 26. doi: 10.1007/s00586-023-08072-x. Online ahead of print.ABSTRACTPURPOSE: Lymphocele formation following anterior lumbar interbody fusion (ALIF) is not common, but it can pose diagnostic and treatment challenges. The purpose of this case is to report for the first time the treatment of a postoperative lymphocele following a multi-level ALIF using a,

Eur Spine J. 2023 Dec 26. doi: 10.1007/s00586-023-08072-x. Online ahead of print.

ABSTRACT

PURPOSE: Lymphocele formation following anterior lumbar interbody fusion (ALIF) is not common, but it can pose diagnostic and treatment challenges. The purpose of this case is to report for the first time the treatment of a postoperative lymphocele following a multi-level ALIF using a peritoneal window made through a minimally invasive laparoscopic approach.

METHODS: Case report.

RESULTS: A 74-year-old male with a history of prostatectomy and pelvic radiation underwent a staged L3-S1 ALIF (left paramedian approach) and T10-pelvis posterior instrumented with L1-5 decompression/posterior column osteotomies for degenerative scoliosis and neurogenic claudication. Three weeks after surgery, swelling of the left abdomen and entire left leg was reported. Computed tomography of the abdomen/pelvis demonstrated a large (19.2 × 12.0 × 15.4 cm) retroperitoneal fluid collection with compression of the left ureter and left common iliac vein. Fluid analysis (80% lymphocytes) was consistent with a lymphocele. Percutaneous drainage for 4 days was ineffective at clearing the lymphocele. For more definitive management, the patient underwent an uncomplicated laparoscopic creation of a peritoneal window to allow passive drainage of lymphatic fluid into the abdomen. Three years after surgery, he had no back or leg pain, had achieved spinal union, and had no abdominal swelling or left leg swelling. Advanced imaging also confirmed resolution of the lymphocele.

S: In this case report, creation of a peritoneal window minimally invasively via a laparoscope allowing passive drainage of lymphatic fluid into the abdomen was safe and effective for management of an abdominal lymphocele following a multi-level ALIF.

PMID:38147084 | DOI:10.1007/s00586-023-08072-x

The London Spine Unit : most advanced spinal centre in London

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Abdominal lymphocele following multi-level anterior lumbar interbody fusion (ALIF) managed with a laparoscopic peritoneal window: case report and review of the literature

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Eur Spine J. 2023 Dec 26. doi: 10.1007/s00586-023-08072-x. Online ahead of print.ABSTRACTPURPOSE: Lymphocele formation following anterior lumbar interbody fusion (ALIF) is not common, but it can pose diagnostic and treatment challenges. The purpose of this case is to report for the first time the treatment of a postoperative lymphocele following a multi-level ALIF using a
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