Case: A 40-year-old man underwent an L5-S1 anterior lumbar interbody fusion (ALIF) and subsequently developed abdominal distention and persistent wound drainage. During wound reexploration, a substantial lymphocele and lymphatic fistula tracking from the ALIF site were visualized and evacuated. The deep space was coated with fibrin sealant. A deep drain and wound vacuum were placed within the retroperitoneal cavity, leading to progressive recovery.
Conclusion: Intraoperative lymphatic injury during anterior spinal surgery can progress to the development of a lymphocele and lymphatic fistula, manageable with an exploratory laparotomy, fibrin sealant, and the use of a wound vacuum to promote fistula sealing.
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