title: Improvement of post-transplant lymphocele treatment in the laparoscopic era.
abstract: 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.
authors.affiliation: Surgical Department, Tx Section, Rikshospitalet, University Hospital, 0027 Oslo, Norway. ole.oyen@rikshospitalet.no
authors.forename: Ole
authors.initials: O
authors.lastname: Øyen
authors.forename: Vikas
authors.initials: V
authors.lastname: Siwach
authors.forename: Pål-Dag
authors.initials: PD
authors.lastname: Line
authors.forename: Per
authors.initials: P
authors.lastname: Pfeffer
authors.forename: Bjørn
authors.initials: B
authors.lastname: Lien
authors.forename: Øystein
authors.initials: Ø
authors.lastname: Bentdal
authors.forename: Aksel
authors.initials: A
authors.lastname: Foss
authors.forename: Bo
authors.initials: B
authors.lastname: Husberg
authors.forename: Bjørn
authors.initials: B
authors.lastname: Edwin
authors.forename: Inge
authors.initials: I
authors.lastname: Brekke
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D010535:Laparoscopy; D008210:Lymphocele / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged