title: Laparoscopic lymphocelectomy: a multi-institutional analysis.
abstract: OBJECTIVE
  Because symptomatic lymphoceles are infrequent, single center studies generally report small numbers of patients. We report a multi-institutional experience with and long-term outcome following laparoscopic lymphocelectomy in 81 patients.
  
  
  METHODS
  Data were obtained from 9 institutions at which at least 5 cases of laparoscopic lymphocelectomy had been performed. Baseline patient demographics, operative time and blood loss, special operative adjunct techniques, postoperative course, convalescence, complications and lymphocele recurrence data were collected and analyzed.
  
  
  RESULTS
  A total of 56 men and 25 women with a mean age of 41 years were included in the study. Lymphocele formed after renal transplantation in 78 patients (96%) and after pelvic lymph node dissection in 3 (4%). Average operating time was 123 minutes with a mean blood loss of 43 ml. Omentopexy was performed in 11 cases (13.6%). No intraoperative stenting of the transplant ureter was performed. Intraoperative complications consisted of laryngospasm, bladder injury, inferior epigastric artery injury and mild renal capsule hematoma in 1 patient each. Conversion to open surgery was required for repair of bladder injury in 1, repair of preexisting hernia in 1, unusually thickened lymphocele wall in 1 and inaccessible lymphocele location in 4 cases. Mean time to ambulation and resumption of regular diet was 1 day, and mean hospital stay was 1.5 days. Postoperative complications included trocar site hernia in 1 and urinary retention in 2. Convalescence averaged 2.5 weeks. During a mean followup of 27 months 5 patients (6%) had lymphocele recurrence.
  
  
  CONCLUSIONS
  Laparoscopic lymphocelectomy is safe, minimally invasive and effective. It is an excellent alternative to the conventional open surgical approach.
authors.affiliation: Department of Urology, Cleveland Clinic Foundation, Ohio 44195, USA.
authors.forename: T H
authors.initials: TH
authors.lastname: Hsu
authors.forename: I S
authors.initials: IS
authors.lastname: Gill
authors.forename: M T
authors.initials: MT
authors.lastname: Grune
authors.forename: R
authors.initials: R
authors.lastname: Andersen
authors.forename: D
authors.initials: D
authors.lastname: Eckhoff
authors.forename: D A
authors.initials: DA
authors.lastname: Goldfarb
authors.forename: R
authors.initials: R
authors.lastname: Gruessner
authors.forename: E E
authors.initials: EE
authors.lastname: Hodge
authors.forename: L C
authors.initials: LC
authors.lastname: Munch
authors.forename: D D
authors.initials: DD
authors.lastname: Nghiem
authors.forename: A
authors.initials: A
authors.lastname: Nye
authors.forename: C R
authors.initials: CR
authors.lastname: Reckard
authors.forename: T
authors.initials: T
authors.lastname: Shaver
authors.forename: R J
authors.initials: RJ
authors.lastname: Stratta
authors.forename: R J
authors.initials: RJ
authors.lastname: Taylor
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008210:Lymphocele / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome