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

AbstractBACKGROUND:
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.
AuthorsI Iwan-Zietek, Z Zietek, T Sulikowski, M Nowacki, L Zair, M Romanowski, M Zukowski, D Rość, M Ostrowski
JournalTransplantation proceedings (Transplant Proc) Vol. 41 Issue 8 Pg. 3073-6 (Oct 2009) ISSN: 1873-2623 [Electronic] United States
PMID19857680 (Publication Type: Journal Article)
Topics
  • Cadaver
  • Female
  • Humans
  • Incidence
  • Kidney Transplantation (adverse effects)
  • Laparoscopy (methods)
  • Living Donors
  • Lymphocele (epidemiology, surgery)
  • Male
  • Minimally Invasive Surgical Procedures (methods)
  • Postoperative Complications (surgery)
  • Time Factors
  • Tissue Donors
  • Treatment Failure

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