Treatment with intraoperative Patent Blue V dye of refractory lymphocele after inguinal lymphadenectomy for squamous cell penile carcinoma.

Abstract OBJECTIVES: To evaluate the potential curative role of the intraoperative use of a dye, the Patent Blue V, for the treatment of refractory lymphoceles by mapping the lymphatic leakage and selectively ligating the opened lymphatics. Inguinal lymphocele is a well-known complication after inguinofemoral lymph node dissection for penile cancer, and a variety of curative approaches have been reported. METHODS: From 1995 to 2007, 40 patients had undergone partial or total penectomy for squamous cell cancer. Superficial inguinal lymph node dissection with saphenous vein sparing or deep lymph node dissection was performed in 15 patients. It was unilateral in 14 and bilateral in 1 patient. When the lymphoceles were refractory to conventional therapy, ligation of the lymphatic vessels after mapping of the leakage with the Patent Blue V dye was the treatment of choice. RESULTS: Overall, 5 lymphoceles were detected in 4 patients that were continuously increasing in size after discharge and were treated conventionally. In the 2 refractory lymphoceles, we then opted for the intraoperative use of a dye, the Patent Blue V, to map the lymphatic leakage and selectively ligate the opened lymphatics. In both cases, complete resolution of the lymphoceles occurred. No complications were observed with this technique. CONCLUSIONS: The presented technique is able to cure persistent lymphoceles refractory to conventional treatment after inguinal lymph node dissection.