Zhou R, Xu J, He J, et al. - The feasibility and efficacy of Pseudomonas aeruginosa-mannose sensitive hemagglutinin (PA-MSHA) were investigated in refractory lymphatic leakage following lymphadenectomy among patients with gynecological cancers. Ten cases with post-operative massive lymphatic leakage who failed to respond to conservative treatment were administered topical PA-MSHA injection of a single dose (2mL) through drainage tube or transvaginal catheter into pelvic or peritoneal cavity. Refractory lymphatic leakage following pelvic and para-aortic lymphadenectomy was observed at the incidence rate of 2.44% (10/409). Quick recovery occurred in all ten patients (100%) and their discharge was done within 72 hours. Findings support the feasibility and effectiveness of topical injection of PA-MSHA of a single dose in treating refractory post operative lymphatic leakage.