Treatment of large, persistent lymphocoeles using an argon beam coagulator and talc.

Background: Lymphocoele formation can be a troublesome surgical complication after lymph node dissection and mobilization of large skin flaps. Occasionally, lymphocoeles persist for prolonged periods despite repeated aspiration. Treatment by sclerotherapy has been recommended, but this requires a prolonged treatment time and often causes intense pain.

Methods: The technique used to treat large, persistent lymphocoeles involved 'painting' the lymphocoele wall with an argon beam coagulator after evacuating its contents. Sterile talc was then distributed liberally through the cavity, a closed suction drain placed and the wound closed.

Results: The procedure was completely successful in each of the four patients treated. After a mean follow-up period of 11 months (range 6-15 months) no lymphocoele recurrence has occurred.

Conclusions: Use of an argon beam coagulator and talc reliably achieves rapid, definitive obliteration of large, persistent lymphocoeles.