Laparoscopic treatment of post renal transplant lymphoceles

Abstract

Laparoscopic fenestration of a peritransplant lymphocele is a safe and effective treatment. The large majority of patients treated with laparoscopic fenestration were discharged within one day of surgery. Unless contraindications exist, laparoscopy should be considered first-line therapy for the surgical treatment of posttransplant lymphocele.

Laparoscopic treatment of lymphoceles after renal transplantation

“…In the literature the recurrence rate following laparoscopic lymphocele fenestration ranges from 4% to 6% (4,6,8). In our series, the recurrence rate after laparoscopy was 4% (1 of 25).…”

“…Although sclerosant therapy has a better success rate than simple aspiration, recurrences remain common, and complications including acute renal failure have been reported (17). No large series have established the benefit of one method of sclerosis over the others (4).…”

“…Since laparoscopic fenestration of post transplant lymphocele was first described by McCullough et al (19) in 1991, multiple groups have shown this approach to be safe and effective (4,6,7). The general benefits of laparoscopic surgery include less aggressiveness to the abdominal wall with quick recovery, favorable cosmetics, reduced blood loss, low postoperative morbidity and short hospital stay.…”

“…Since laparoscopy has been employed to treat post transplant lymphocele, a number of complications have been described (4,8). Injury of the urinary tract, particularly of the transplanted ureter, has been described as a major drawback of laparoscopic lymphocele drainage (4), and an incidence rate as high as 20% has been reported (16).…”

“…The significant majority of post transplant lymphoceles occurs within the first 3 months after surgery (4). Although most collections are asymptomatic and resolve spontaneously, some may lead to more serious complications.…”