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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 Spinal Stenosis

This article reports on the treatment of a rare case of lymphocele formation after anterior lumbar interbody fusion (ALIF) surgery. The patient, a 74-year-old male, developed swelling in the left abdomen and leg three weeks after undergoing multi-level ALIF surgery. CT scans revealed a large retroperitoneal fluid collection, consistent with a lymphocele, which was compressing nearby structures. Percutaneous drainage was unsuccessful, so the patient underwent a minimally invasive laparoscopic procedure to create a peritoneal window for passive drainage of lymphatic fluid into the abdomen. Three years later, the patient had no complications, achieved spinal union, and showed resolution of the lymphocele. The study concludes that this approach was safe and effective in managing an abdominal lymphocele after multi-level ALIF surgery

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

CONCLUSIONS: 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.

CONCLUSIONS: 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

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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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