Skip to main content
SpringerLink
Log in

Successful doxycycline treatment of lymphatic fistulas: report of five cases and review of the literature

  • Case Management and Clinical Consequences
  • Published:
Langenbeck's Archives of Surgery Aims and scope Submit manuscript

Abstract

Background and aims

Lymphatic fistulas are commonly known complications after lymph node or soft tissue resection, requiring long and sometimes difficult therapy. Doxycycline is an antibiotic agent, which was used in the treatment of pneumothoraces and pleural effusions. The aim of the study was to evaluate the effect of local doxycycline instillation on postoperative lymphatic effusions.

Materials and methods

Five patients with postoperative lymphatic fistulas of different locations (inguinal, gluteal, and thoracic) were included. Patients received local doxycycline instillation after a postoperative observation period of 19–27 days without spontaneous closure of the fistulas.

Results

Postoperative lymphatic fistulas closed after a single injection of doxycycline in four out of five patients within 2 days, in one patient, injection had to be repeated to achieve closure of the fistula. Drain removal was possible within 4 days after instillation in all patients; no complications occurred.

Conclusions

Doxycycline can be used for treatment of persistent postoperative lymphatic fistulas in different locations. In further studies, this therapeutic concept should be evaluated with larger numbers of patients with regard to the ideal point of time, frequency, and mode of application.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Serpell JW, Carne PW, Bailey M (2003) Radical lymph node dissection for melanoma. ANZ J Surg 73:294–299 (May)

    Article  PubMed  Google Scholar 

  2. Nelson BA, Cookson MS, Smith JA Jr, Chang SS (2004) Complications of inguinal and pelvic lymphadenectomy for squamous cell carcinoma of the penis: a contemporary series. J Urol 172:494–497 (Aug)

    Article  PubMed  Google Scholar 

  3. Bouchot O, Rigaud J, Maillet F, Hetet JF, Karam G (2004) Morbidity of inguinal lymphadenectomy for invasive penile carcinoma. Eur Urol 45:761–765; discussion 765–766 (Jun)

    Article  PubMed  Google Scholar 

  4. Giovannini I, Giuliante F, Chiarla C, Ardito F, Vellone M, Nuzzo G (2005) Non-surgical management of a lymphatic fistula, after laparoscopic colorectal surgery, with total parenteral nutrition, octreotide, and somatostatin. Nutrition 21:1065–1067 (Oct)

    Article  PubMed  CAS  Google Scholar 

  5. Cnotliwy M, Gutowski P, Petriczko W, Turowski R (2001) Doxycycline treatment of groin lymphatic fistulae following arterial reconstruction procedures. Eur J Vasc Endovasc Surg 21:469–470 (May)

    Article  PubMed  CAS  Google Scholar 

  6. Clarke SA, Lakhoo K, Sherwood W (2005) Somatostatin for intractable postoperative chylothorax in a premature infant. Pediatr Surg Int 21:390–391 (May)

    Article  PubMed  CAS  Google Scholar 

  7. Valentine CN, Barresi R, Prinz RA (2002) Somatostatin analog treatment of a cervical thoracic duct fistula. Head Neck 24:810–813 (Aug)

    Article  PubMed  Google Scholar 

  8. Heffner JE, Standerfer RJ, Torstveit J, Unruh L (1994) Clinical efficacy of doxycycline for pleurodesis. Chest 105:1743–1747 (Jun)

    Article  PubMed  CAS  Google Scholar 

  9. Herrington JD, Gora-Harper ML, Salley RK (1996) Chemical pleurodesis with doxycycline 1 g. Pharmacotherapy 16:280–285 (Mar–Apr)

    PubMed  CAS  Google Scholar 

  10. Sassoon CS (1995) The etiology and treatment of spontaneous pneumothorax. Curr Opin Pulm Med 1:331–338 (Review, Jul)

    PubMed  CAS  Google Scholar 

  11. Ji YZ, Zheng JH, Chen JN, Wu ZD (1993) Microsurgery in the treatment of chyluria and scrotal lymphangial fistula. Br J Urol 72:952–954 (Dec)

    Article  PubMed  CAS  Google Scholar 

  12. Kwaan JH, Bernstein JM, Connolly JE (1979) Management of lymph fistula in the groin after arterial reconstruction. Arch Surg 114:1416–1418 (Dec)

    PubMed  CAS  Google Scholar 

  13. Waclawiczek HW, Pimpl W (1986) Lymph fistulae following lymph node dissections—prevention and treatment using fibrin gluing. Chirurg 57:330–331 (May)

    PubMed  CAS  Google Scholar 

  14. Brun JL (1995) Postoperative lymphoceles and lymphatic fistula in gynaecologic and breast neoplasm. Bull Cancer 82:711–716 (Review, Sep)

    PubMed  CAS  Google Scholar 

  15. Neu B, Gauss G, Haase W, Dentz J, Husfeldt KJ (2000) Radiotherapy of lymphatic fistula and lymphocele. Strahlenther Onkol 176:9–15 (Jan)

    Article  PubMed  CAS  Google Scholar 

  16. Browse NL, Wilson NM, Russo F, al-Hassan H, Allen DR (1992) Aetiology and treatment of chylous ascites. Br J Surg 79:1145–1150 (Nov)

    Article  PubMed  CAS  Google Scholar 

  17. Cope C (1998) Diagnosis and treatment of postoperative chyle leakage via percutaneous transabdominal catheterization of the cisterna chyli: a preliminary study. J Vasc Interv Radiol 9:727–734 (Sep–Oct)

    Article  PubMed  CAS  Google Scholar 

  18. DiBardino DJ, Vanatta JM, Fagan SP, Awad SS (2002) Acute respiratory failure after pleurodesis with doxycycline. Ann Thorac Surg 74:257–258 (Jul)

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Im Neuenheimer Feld 110, Heidelberg 69120, Germany

    Thilo Hackert, Jens Werner, Martin Loos, Markus W. Büchler & Jürgen Weitz

Authors
  1. Thilo Hackert
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jens Werner
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Martin Loos
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Markus W. Büchler
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jürgen Weitz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Thilo Hackert.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hackert, T., Werner, J., Loos, M. et al. Successful doxycycline treatment of lymphatic fistulas: report of five cases and review of the literature. Langenbecks Arch Surg 391, 435–438 (2006). https://doi.org/10.1007/s00423-006-0050-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00423-006-0050-8

Keywords

Search

Navigation