The treatment of recurrent pelvic lymphocysts with marsupialization and functioning omental flap.

A new treatment for recurrent pelvic lymphocysts is reviewed. Nine women with recurrent symptomatic lymphocyst were treated by marsupialization of the lymphocyst to the peritoneal cavity and functioning omental flap. The omental flap was dissected off the greater curve of the stomach maintaining its blood supply from the appropriate gastroepiploic vessels. The flap functioned by absorbing the lymph that previously accumulated in the lymphocyst. The efficacy of treatment was accessed both clinically and with diagnostic imaging. The pelvic lymphocysts were successfully treated in all 9 cases. There was no significant morbidity and the average hospital stay was 7 days. Marsupialization of pelvic lymphocysts combined with an omental flap is effective, not associated with increased morbidity and has a very low recurrence rate.