Laparoscopic Fenestration Versus Percutaneous Catheter Drainage for Lymphocele Treatment After Kidney Transplantation

Lee, Hyung Soon; Joo, Dong Jin; Huh, Kyu Ha; Kim, M.S.; Kim, S.I.; Kim, Y.S.; Lee, W.J.

doi:10.1016/j.transproceed.2012.11.019

Cited by 17 publications

(5 citation statements)

References 13 publications

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“…). Eighty‐seven articles met the inclusion criteria and were included in the report. Seventy‐six articles reported on lymphoceles only, four articles on lymphorrhoea, and seven articles on lymphocele and lymphorrhoea.…”

Section: Resultsmentioning

confidence: 99%

Consensus on definition and severity grading of lymphatic complications after kidney transplantation

Mehrabi

Kulu

Sabagh

et al. 2020

British Journal of Surgery

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Background: The incidence of lymphatic complications after kidney transplantation varies considerably in the literature. This is partly because a universally accepted definition has not been established. This study aimed to propose an acceptable definition and severity grading system for lymphatic complications based on their management strategy. Methods: Relevant literature published in MEDLINE and Web of Science was searched systematically. A consensus for definition and a severity grading was then sought between 20 high-volume transplant centres.Results: Lymphorrhoea/lymphocele was defined in 32 of 87 included studies. Sixty-three articles explained how lymphatic complications were managed, but none graded their severity. The proposed definition of lymphorrhoea was leakage of more than 50 ml fluid (not urine, blood or pus) per day from the drain, or the drain site after removal of the drain, for more than 1 week after kidney transplantation. The proposed definition of lymphocele was a fluid collection of any size near to the transplanted kidney, after urinoma, haematoma and abscess have been excluded. Grade A lymphatic complications have a minor and/or non-invasive impact on the clinical management of the patient; grade B complications require non-surgical intervention; and grade C complications require invasive surgical intervention.Conclusion: A clear definition and severity grading for lymphatic complications after kidney transplantation was agreed. The proposed definitions should allow better comparisons between studies.

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Section: Resultsmentioning

confidence: 99%

Consensus on definition and severity grading of lymphatic complications after kidney transplantation

Mehrabi

Kulu

Sabagh

et al. 2020

British Journal of Surgery

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“…This wide range of reported incidences between studies may be explained through the investigation of different postoperative outcomes and by the use of different definitions for lymphoceles. These inconsistencies in patient selection and management strategies between studies mean that analytic comparisons cannot be made [ 5 , 11 , 12 , 13 , 14 , 15 , 16 ]. Furthermore, different conservative, non-surgical, and surgical methods have been used to treat lymphoceles [ 6 , 7 , 17 ], and these treatments cannot be compared because of the heterogeneity of the data.…”

Section: Discussionmentioning

confidence: 99%

Validating Consensus-Defined Severity Grading of Lymphatic Complications after Kidney Transplant

Sabagh

Mohammadi

Ramouz

et al. 2021

JCM

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Lymphatic complications after kidney transplantation (KTx) are associated with morbidities such as impaired wound healing, thrombosis, and organ failure. Recently, a consensus regarding the definition and severity grading of lymphoceles has been suggested. The aim of the present study was to validate this classification method. All adult patients who underwent KTx between December 2011 and September 2016 in our department were evaluated regarding lymphoceles that were diagnosed within 6 months after KTx based on the recent definition. Patients with lymphoceles were categorized according to the classification criteria, and clinical outcomes were compared between the groups. In our department, a total of 587 patients underwent KTx between 2011 and 2016. Lymphoceles were detected after KTx in 90 patients (15.3%). Among these patients, 24 (26.6%) had grade A lymphoceles, 14 (15.6%) had grade B, and 52 (57.8%) had grade C. The median duration times of intermediate care (IMC) and hospital stay were significantly higher among patients with grade C lymphoceles than they were among patients with grade A and B lymphoceles. Significantly more patients with grade C lymphoceles were readmitted to the hospital for treatment. The recently published definition and severity grading of lymphoceles after KTx is an easy-to-use and valid classification system, which may facilitate the comparison of results from different studies on lymphoceles after KTx.

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“…Percutaneous drainage procedures are also attractive since they are less invasive, cost effective, and can be done as an outpatient. However, even when accompanied by the injection of sclerosing agents such as tetracycline, povidone iodine, and ethanol, percutaneous drainage techniques have resulted in treatment failure rates from 35% to 74% (16)(17)(18)(19). In 2003, Chin et al reported a series of eight kidney transplant patients undergoing fibrinogen and bovine aprotinin injections for the treatment of symptomatic lymphoceles (18).…”

Section: Discussionmentioning

confidence: 99%

Fibrin Glue Injections: A Minimally Invasive and Cost-Effective Treatment for Post–Renal Transplant Lymphoceles and Lymph Fistulas

Presser

Kerr

Gao

et al. 2016

American Journal of Transplantation

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Pelvic lymphoceles/lymph fistulas are commonly observed after kidney allotransplantation, especially when the kidney is placed in a retroperitoneal position. While the majority are <5 cm in diameter and resolve without intervention, some may continue to enlarge, and cause local or systemic symptoms or graft dysfunction. Among 1662 recipients of both living and deceased donor kidney transplants between January 2003 and July 2014, we found 46 (2.7%) patients with symptomatic lymphoceles requiring intervention. We studied the clinical outcomes and charges for three treatment modalities including open surgical drainage (22), laparoscopic surgical drainage (11), and percutaneous fibrin glue injections into the drained lymphocele cavity (13). The patient demographics and clinical characteristics were comparable for each treatment group, although maintenance immunosuppressive drugs differed by era. We found fibrin glue injections resulted in significantly lower (p = 0.04) rates of recurrence (1; 7.7%) than either laparoscopic (6; 54%) or open surgical drainage (6; 27.3%). In addition, fibrin glue injections generated significantly (p < 0.001) lower median ($4559) charges compared to either laparoscopic ($26 330) or open surgical drainage ($23 758). Fibrin glue treatment has the advantage of being an outpatient procedure, performed with the patient under local anesthesia, and does not incur the expense of an operative procedure or hospital admission associated with laparoscopic or open surgery.

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Laparoscopic Fenestration Versus Percutaneous Catheter Drainage for Lymphocele Treatment After Kidney Transplantation

Cited by 17 publications

References 13 publications

Consensus on definition and severity grading of lymphatic complications after kidney transplantation

Consensus on definition and severity grading of lymphatic complications after kidney transplantation

Validating Consensus-Defined Severity Grading of Lymphatic Complications after Kidney Transplant

Fibrin Glue Injections: A Minimally Invasive and Cost-Effective Treatment for Post–Renal Transplant Lymphoceles and Lymph Fistulas

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