| [Objective] To explore the clinical feasibility and safety of DSA guided direct lymphangiography embolization (DLS) for Post-surgical pelvic lymphatic vessel leakage (PSPLL) of gynecological malignancies. [Methods] This study is a retrospective analysis of 11 PSPLL patients treated at Zhejiang Cancer Hospital between September and December 2024. All patients experienced post-surgical pelvic lymphatic leakage, one with chylothorax, all treated after not responding to conservative treatment. The superficial inguinal lymph nodes were punctured through ultrasound-guided, and the position of pelvic lymphatic vessel leakage was precisely located under DSA guidance. The clinical efficacy and the occurrence of complications were observed at 1 week and 1 month after the intervention. [Results] 11 patients received a total of 14 DLS, and the contrast technique success rate was 100%. After intervention therapy, 8 of 11 patients were cured, 1 improved, 1 failed and 1 relapsed, with a response rate of 81.8%. Among the 11 patients, 9 had abdominal pain, 4 had mild pain relief after intervention, 5 moderate relief, pain relief rate of 100%; 5 patients had post-surgical lower extremity lymphedema (PSLEL), 1 significantly improved, 3 mild improvement, 1 ineffective, treatment effective rate was 80%. The complication rate of DLS was 14.2%, mainly mild pain at the puncture point and no other serious complications were showed. |
