- Design
- Prospective single-centre imaging study
- Population
- 40 men with 45 symptomatic lymphoceles after prostatectomy with pelvic node dissection
- Primary outcome
- Anatomical site of lymphatic leak on lymphangiography
- Effect
- Cloquet region 42/43 leaks (98%, 95% CI 88 to 100); embolisation success 84%
A prospective single-centre study in The Journal of Urology, published on 9 October, performed lymphangiography on 40 men with 45 symptomatic lymphoceles after radical prostatectomy with extended or salvage pelvic node dissection.
An active leak was found in 43 of 45 lymphoceles, and 42 of 43 (98%) arose in the region of Cloquet's node at the femoral canal. Most came from afferent vessels draining into an excised Cloquet's node. Embolisation of the leak succeeded clinically in 84%.
The authors note that Cloquet's node is rarely involved by prostate cancer and propose sparing it, with careful lymphostasis, to cut lymphocele risk without compromising staging. That proposal has not been tested in a comparative study.
- Seal lymphatics carefully at the distal external iliac region during pelvic node dissection.
- Consider whether removing Cloquet's node adds staging value in prostate cancer.
- Refer symptomatic lymphoceles for lymphangiography and embolisation where available; it succeeded in 84%.
- Warn patients having extended dissection about lymphocele symptoms — leg swelling, pelvic pain, urinary frequency.
Why it matters
Lymphoceles are the main argument against extended node dissection, and this points to a fixable source.
Don't overread it
A single-centre descriptive study; it does not show that sparing Cloquet's node prevents lymphoceles.
The statistics, in plain English
98% is 42 of 43 leaks, with a confidence interval of 88% to 100%, so the finding is consistent even with small numbers.
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