Delayed Infection of a Lymphocele following Robot-Assisted R
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Abstract :
Pelvic lymphoceles are an infrequent complication after pelvic surgery and develop shortly after the surgery in most cases. We experienced a case of delayed infection of a lymphocele 6 months after robot-assisted radical prostatectomy (RARP) and pelvic lymphadenectomy. In this case, antimicrobial chemotherapy and percutaneous drainage were effective, and there was no recurrence of the disease. Most urologists do not recognize that infected lymphoceles can develop a long time after surgery; thus, infected lymphoceles should be kept in mind in patients with nonspecific infectious symptoms, regardless of the length of time after surgery.

Case :
A 79-year-old Japanese man with a prostate-specific antigen level of 6.5??g/ml presented to our department. He was diagnosed as having localized adenocarcinoma of the prostate, Gleason 3+3, cT2c N0 M0. He underwent transperitoneal non-nerve-sparing robot-assisted laparoscopic radical prostatectomy (RARP) with pelvic lymph node dissection, and a pelvic drain was placed for 3 days. The pathologic examination revealed that the tumor was pT2c with Gleason 3+5, and none of the dissected lymph nodes were malignant. On the 7th day after surgery, he was discharged from hospital with no complications. Six months after the operation, he visited a primary care doctor complaining of fever and fatigue. For a week, his symptoms continued. He was referred to the general medicine department in our hospital. A pelvic computed tomography (CT) scan showed a pelvic cyst, and a blood test revealed an abnormally high inflammatory reaction; he was then sent to our department and admitted.......