Laparoscopic treatment of symptomatic lymphoceles after kidney transplantation.
BACKGROUND
The incidence of lymphocele after kidney transplantation ranges from 0.6% to 18%. This study examines the use of laparoscopic ultrasound for the location of lymphoceles during laparoscopic drainage.


METHODS
Between July 1993 and October 1998, we performed 147 kidney transplants. A symptomatic lymphocele was observed in 19 patients (12.9%). All of these patients underwent peritoneal laparoscopic fenestration of the lymphocele. The graft, kidney hilum, ureter, iliac vessels, and lymphoceles were identified by laparoscopic ultrasound.


RESULTS
All but one patient were discharged within 24 h. One recurrence (5.2%), which was successfully treated by laparoscopy, was observed at a mean follow-up of 15.5 months. We had one complication (5.2 %)-a left hydrocele that occurred 2 days after drainage of a lymphocele located in the left iliac fossa.


CONCLUSIONS
Laparoscopic peritoneal drainage of posttransplant lymphoceles shares the well known advantages of laparoscopy. Furthermore, laparoscopic ultrasound is a useful tool that allows the recognition of anatomical structures and decreases the risk of iatrogenic lesions.
Risaliti
A
A
Department of Surgery, University Hospital of Udine, School of Medicine, Italy.
Corno
V
V
Donini
A
A
Cautero
N
N
Baccarani
U
U
Pasqualucci
A
A
Terrosu
G
G
Cedolini
C
C
Bresadola
F
F
D000328:Adult; D019160:Endosonography; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D010535:Laparoscopy; D008210:Lymphocele / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery*; D012008:Recurrence; D012187:Retroperitoneal Space; D012189:Retrospective Studies; D013396:Suction / Q000379:methods; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color