Laparoscopic drainage of lymphoceles after kidney transplantation: Indications and limitations

Gruessner, Rainer W.G.; Fasola, Carlos G.; Benedetti, Enrico; Foshager, Mary C.; Gruessner, Angelika C.; Matas, Arthur J.; Najarían, John S.; Goodale, Robert L.

doi:10.1016/s0039-6060(05)80204-1

Cited by 74 publications

(40 citation statements)

References 24 publications

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“…The incidence of lymphoceles following renal transplantation has been reported to be less than 1% up to 20%, whereas only about 5% become symptomatic (Table 1). Lymphoceles usually develop within 3 months after renal transplantation, with a range from 1 week up to several years [15,39].…”

Section: Discussionmentioning

confidence: 99%

“…Lymph vessel traumatization at the operating site or in the donor organ, acute rejection episodes, and certain drugs such as heparin, steroids, and diuretics are believed to be the most common causes of posttransplant lymphoceles [1,13,23,26,39,45]. Patient who have had multiple renal transplantations are also at higher risk for the development of a lymphocele [15,40].…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic fenestration of posttransplant lymphoceles

et al. 2002

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Laparoscopic fenestration of posttransplant lymphoceles

et al. 2002

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“…The laparoscopic approach offers the advantages of minimal trauma and fast recovery, as concluded by almost all authors [l, 5,8,10,13,19,211. However, according to several reports [lo, 13,17,201, and demonstrated by our early experience, there is a significant risk of injury to vital structures (ureter/renal pelvis/ bladder/iliac vessels).…”

Section: Discussionmentioning

confidence: 99%

Improvement of post-transplant lymphocele treatment in the laparoscopic era

et al. 2002

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Post-transplant lymphoceles are a common problem after renal transplantation, often inflicting the graft or adjacent iliac veins. Since 1991, there have been many reports on laparoscopic fenestration as the treatment of choice, but no larger series has been presented. At our department, 63 laparoscopic procedures were performed between 1993 and 2001 among 1502 renal graft recipients. The laparoscopic operation time, conversion rate, hospital stay, and complications have all decreased progessively. Duration of hospital stay and convalescence was markedly longer in patients treated with conventional open surgery (27 patients). Rejections, CMV disease, and post-transplant reoperations seem to have an increased incidence in the lymphocele population. According to our experience, laparoscopic fenestration is the superior treatment for symptomatic lymphoceles, allowing minimal trauma and fast recovery. Our series suggests that the rate of complications/graft injury decreases progressively with experience. Laparoscopic ultrasound seems useful in difficult cases. Prophylactic measures should be emphasised at the time of transplantation and reoperations.

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“…Other tips for anatomically difficult lymphoceles lateral or inferior to the transplant kidney, which without a common wall between the lymphocele and peritoneal cavities has been reported by placing a cable of 2 internalized peritoneal dialysis catheters between the lymphoceles and the peritoneal cavity for maintaining permanent lymphoperitoneal drainage (Matin & Gill, 2000). Other potential problems associated with laparoscopic marsupialization of lymphoceles consist of injury to other organs (6%), and open conversion (6%) (Atray et al, 2004;Gruessner et al,1995).…”

Section: Laparoscopic Marsupialization Of Lymphocelesmentioning

confidence: 99%