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Minimally invasive methods for the treatment of lymphocele after kidney transplantation.

Abstract：

BACKGROUND:One common complication after kidney transplantation is a lymphocele. The aim of our work was an analysis of incidence of lymphocele and the effectiveness of minimal invasive methods in the management of this complication. MATERIALS AND METHODS:The examined group was consisted of 158 patients (68 female and 90 male) with end-stage renal disease who underwent kidney transplantation. RESULTS:Twenty-one patients (13%) developed symptoms of lymphocele after transplantation procedure within an average time of 34 weeks. The clinical symptoms included a decrease in 24-hour urine collection, an increase in plasma creatinine concentration, abdominal discomfort, lymphorrhea with a surgical wound dehiscence, voiding problems of urgency or vesical tenesmus, febrile states, or symptoms of deep vein thrombosis. The following methods were applied with variable efficacy: aspiration with recurrence 75%; percutaneous drainage with 55%, effectiveness; laparoscopic fenestration with 72% satisfactory outcomes (1 patient presented an excessive bleeding after the procedure), and classic surgery with favorable results. CONCLUSION:Percutaneous drainage guided by ultrasonic imaging should be recommended as the first attempt to cure a lymphocele. Laparoscopy is a feasible, safe technique that should be used after unsuccessful percutaneous drainage. A larger series of patients is required to confirm the superiority of minimal invasive methods to the classical approach.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Iwan-Zietek I,Zietek Z,Sulikowski T,Nowacki M,Zair L,Romanowski M,Zukowski M,Rość D,Ostrowski M

doi

10.1016/j.transproceed.2009.09.045

subject

Has Abstract

pub_date

2009-10-01 00:00:00

pages

3073-6

issue

8

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(09)01293-7

journal_volume

41

pub_type

杂志文章

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