Abstract | BACKGROUND: The etiopathogenesis of lymphoceles remains incompletely understood. The aim of our work was to analyze the perturbations of blood coagulation process for their possible impact on the etiology of lymphoceles. Additionally we performed an evaluation of the incidence and effectiveness of treatment methods for lymphoceles. MATERIALS AND METHODS: RESULTS: At 7 years follow-up 27 (11%) recipients had developed symptomatic lymphoceles, namely abdominal discomfort, a palpable mess in the lower abdomen, arterial hypertension, infection of the operative site with fever, lymphorrhoea with surgical wound dehiscence, decreased diurnal urine output with an elevated plasma creatinine, voiding problems of urgency and vesical tenesmus, and/or symptoms of deep vein thrombosis. We applied the following methods of treatment aspiration alone, percutaneous drainage, laparoscopic fenestration or open surgery. In two only patients did perform open surgery. Since 2008 we have not performed an aspiration alone because of high rate of recurrence (almost 100%) and abandoned open surgery in favor of a laparoscopic approach. Our minimally invasive surgery includes percutaneous drainage guided by ultrasound and a laparoscopic procedure with 100% effectiveness. The examined hemostatic parameters revealed decreased concentrations of TAT complexes and F1+2 in subjects with lymphocele showing positive predictive values of 33% and 41% respectively. The negative predictive values for TAT complexes and F1+2 were 14% and 10%, respectively, suggesting decreased blood coagulation activity among effected recipients. Altered blood coagulation processes may explain some aspects of the disturbances of postoperative obliteration of damaged lymphatic vessels and formation of pathological lymph collection afterward. CONCLUSIONS: Perturbations of blood coagulation may be one cause for a lymphocele.
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Authors | Z Ziętek, I Iwan-Ziętek, T Sulikowski, J Sieńko, M Nowacki, M Zukowski, M Kaczmarczyk, A Ciechanowicz, M Ostrowski, D Rość, M Kamiński |
Journal | Transplantation proceedings
(Transplant Proc)
Vol. 43
Issue 8
Pg. 3008-12
(Oct 2011)
ISSN: 1873-2623 [Electronic] United States |
PMID | 21996212
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2011 Elsevier Inc. All rights reserved. |
Topics |
- Blood Coagulation Disorders
(etiology)
- Female
- Hemostasis
- Humans
- Kidney Transplantation
(adverse effects)
- Lymphocele
(blood, etiology, surgery)
- Male
- Minimally Invasive Surgical Procedures
- Postoperative Complications
(blood, etiology, surgery)
- Retrospective Studies
- Risk Factors
- Treatment Outcome
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