Topical Application of Pseudomonas aeruginosa-Mannose Sensitive Hemagglutinin (PA-MSHA) for Refractory Lymphatic Leakage Following Lymphadenectomy in Patients with Gynecological Malignancies

• Main Authors: Zhou R, Xu J, He J, Gong Y, Wang H, Linghu H
• Format: Article
• Language: English
• Published: Dove Medical Press 2021-06-01
• Series: Cancer Management and Research
• Subjects: pseudomonas aeruginosa-mannose sensitive hemagglutinin (pa-msha) injection; pelvic and para-aortic lymphadenectomy; lymphatic leakage; chylous leakage.
• Online Access: https://www.dovepress.com/topical-application-of-pseudomonas-aeruginosa-mannose-sensitive-hemagg-peer-reviewed-fulltext-article-CMAR
• ISSN: 1179-1322

Rong Zhou,* Jie Xu,* Jingke He, Yao Gong, Hui Wang, Hua Linghu Department of Obstetrics & Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of China*These authors contributed equally to this workCorrespondence: Hua LinghuDepartment of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of ChinaTel [phone]Fax [phone]Email [e-mail]: To observe the feasibility and efficacy of Pseudomonas aeruginosa-mannose sensitive hemagglutinin (PA-MSHA) in refractory lymphatic leakage following lymphadenectomy among patients with gynecological cancers.Patients and Methods: Ten cases with post-operative massive lymphatic leakage were collected, in which patients failed to respond to conservative treatment. Topical PA-MSHA injection of a single dose (2mL) was performed through drainage tube or transvaginal catheter into pelvic or peritoneal cavity. Drainage volumes and side effects were recorded.Results: The incidence of refractory lymphatic leakage following pelvic and para-aortic lymphadenectomy was 2.44% (10/409). All ten patients (100%) had quick recovery and were discharged within 72 hours. Among them, one patient (10%) experienced fever and six patients (60%) experienced abdominal pain, one of which was moderate and relieved by routine analgesic treatment. During 11 (6– 38) months of follow-up time, no long-term side effect was observed.Conclusion: Topical injection of PA-MSHA of a single dose appears a feasible and effective treatment for refractory post-operative lymphatic leakage.Keywords: Pseudomonas aeruginosa-mannose sensitive hemagglutinin (PA-MSHA) injection, pelvic and para-aortic lymphadenectomy, lymphatic leakage, chylous leakage