Intraperitoneal catheter drainage of lymphocele: an outpatient procedure.
Laparoscopic marsupialization of lymphocele carries 13% recurrence rate, 6% injury to other organs, 12% omentoplasty, 6% open conversion and 1.8 average hospital days. A novel, simplified technique of intraperitoneal catheter drainage of lymphocele is described. Under ultrasound guidance and using the Seldinger technique, a 13F Hickman catheter was introduced into the lymphocele and connected subcutaneously to a small peritoneal window performed 5 cm apart. During the last 8 years the procedure was performed under local anesthesia in 14 patients on an outpatient basis with success (e.g. resolution of both hydronephrosis and lymphocele). One wound infection required removal of the catheter without recurrence. In another patient laparoscopy showed retraction of the catheter under the peritoneum as cause for lymphocele recurrence. In all cases absence of injury to the GU tract was confirmed by absence of extravasation of indigo carmine given intravenously. Intraperitoneal catheter drainage of post-transplant lymphocele is an effective outpatient procedure. It avoids the drawbacks of general anesthesia required by open and laparoscopic marsupialization procedures and deserves to be evaluated in a multicenter study.
Nghiem
Dai D
DD
Department of Surgery, Allegheny General Hospital, Pittsburgh, PA, USA. dnghiem@wpahs.org
Beckman
Irwin
I
D000556:Ambulatory Surgical Procedures / Q000379:methods*; D002404:Catheterization; D004322:Drainage / Q000379:methods*; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D010535:Laparoscopy; D008210:Lymphocele / Q000601:surgery*; D011183:Postoperative Complications / Q000601:surgery*