| Item type: | Article | ||||
|---|---|---|---|---|---|
| Journal or Publication Title: | International Journal of Radiation Oncology*Biology*Physics | ||||
| Publisher: | Elsevier | ||||
| Place of Publication: | NEW YORK | ||||
| Volume: | 111 | ||||
| Number of Issue or Book Chapter: | 4 | ||||
| Page Range: | pp. 949-958 | ||||
| Date: | 2021 | ||||
| Institutions: | Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie Medicine > Lehrstuhl für Strahlentherapie Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Klinische Studien | ||||
| Identification Number: |
| ||||
| Keywords: | PAINFUL HEEL SPUR; ARTERIAL RECONSTRUCTION; DOXYCYCLINE TREATMENT; RADIOTHERAPY; MANAGEMENT; INCISION; CANCER; FLAPS; | ||||
| Dewey Decimal Classification: | 600 Technology > 610 Medical sciences Medicine | ||||
| Status: | Published | ||||
| Refereed: | Yes, this version has been refereed | ||||
| Created at the University of Regensburg: | Yes | ||||
| Item ID: | 55666 |
Web of ScienceAbstract
Purpose: Lymphatic fistulas are common complications after vascular surgery, especially in the groin, and can lead to a prolongation of the inpatient stay, wound infections, and follow-up operations. Radiation therapy is one of the nonsurgical treatment options; however, evidence and discussion about the ideal dosage and timing are limited. Methods and Materials: The analysis was performed on ...
Abstract
Purpose: Lymphatic fistulas are common complications after vascular surgery, especially in the groin, and can lead to a prolongation of the inpatient stay, wound infections, and follow-up operations. Radiation therapy is one of the nonsurgical treatment options; however, evidence and discussion about the ideal dosage and timing are limited. Methods and Materials: The analysis was performed on patients from a German university hospital and included 191 patients with 206 lymphatic fistulas from 2005 to 2016. Four different endpoints were analyzed. The patients were irradiated with a fraction dose of 3 Gy up to a cumulative dose of 9 Gy (94 cases) or 18 Gy (112 cases). The median age of the patients was 70.5 years; 74% were male and 26% were female. Vascular surgery included bypass grafts (52%), thromboendarterectomy/ patch angioplasty (26%), and vascular access for aortic endografts (22%). Results: The response to radiation therapy for the 4 different endpoints was 88% (25% decrease in secretion volume), 80% (secretion <50 mL per 24 hours), 81% (removal of the drainage), and 75% (freedom from any intervention). The overall response for all 4 endpoints was 63% (129 of 206) after completion of radiation therapy and 34% (70 of 206) after 1 course with a total dose up to 9 Gy. The median lymphatic secretion was 150 mL per 24 hours before radiation therapy and 60 mL per 24 hours 1 day after the end of therapy. The drainage could be removed a median of 3 days after radiation therapy completion. There was no significant difference between patients starting the radiation within 5 to 9 days or >= 10 days postoperatively (P = .971; OR, 0.99; 95% confidence interval, 0.56-1.74). No relevant factors influencing the response rate could be identified. Reoperation was required in 50 of the 206 cases (25%): 24 (12%) owing to persistent lymphatic fistula and complications and 26 (13%) owing to wound and/or vascular complications. Conclusions: Radiation therapy seems to be an effective nonsurgical treatment option for reducing lymphatic secretion after vascular surgery in the groin. Starting radiation early (<= 9 days) or late (>10 days) postoperatively did not affect the success rate. (C) 2021 Elsevier Inc. All rights reserved.
Metadata last modified: 29 Feb 2024 12:11
Altmetric