title: Novel technique to prevent lymphocele recurrence after laparoscopic lymphocele fenestration in renal transplant patients.
abstract: OBJECTIVE
  To describe the use of nonabsorbable polymer ligating (NPL) clips to prevent recurrence after laparoscopic lymphocele fenestration and to determine the efficacy and safety of this treatment in renal-transplant patients at our center.
  
  
  METHODS
  From December 2000 to October 2005, nine patients with a mean age of 38.5 years (range 26-54 years) and symptomatic lymphoceles were treated laparoscopically among 144 renal-transplant patients. The overall incidence of symptomatic lymphocele was 6.2% (9/144). The mean time from transplantation to diagnosis was 55.5 days (range 20-98 days). Patient and lymphocele characteristics, complications, recurrence rate, and outcomes of this procedure were analyzed retrospectively.
  
  
  RESULTS
  Laparoscopic treatment was successful in eight patients; the other was converted to open surgery. One patient sustained an allograft-ureteral injury. The mean operative time was 90.7 minutes (range 75-120 minutes), and the mean postoperative stay was 4.1 days (range 1-7 days). Lymphocele recurrence was found in the first two patients after laparoscopic surgery without NPL clips. With a mean follow-up of 42.3 months (range 31-51 months), no recurrence was observed in patients in whom NPL clips were used to maintain the patency of the peritoneal window. No late laparoscopy-related complications occurred.
  
  
  CONCLUSIONS
  Laparoscopic lymphocele fenestration with NPL clips is a safe, technically easy, and efficacious procedure for the treatment of symptomatic lymphoceles after renal transplantion.
authors.affiliation: Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. sittm@mahidol.ac.th
authors.forename: Tawatchai
authors.initials: T
authors.lastname: Taweemonkongsap
authors.forename: Sittiporn
authors.initials: S
authors.lastname: Srinualnad
authors.forename: Chaiyong
authors.initials: C
authors.lastname: Nualyong
authors.forename: Anupan
authors.initials: A
authors.lastname: Tantiwong
authors.forename: Suchai
authors.initials: S
authors.lastname: Soontrapa
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D010535:Laparoscopy; D008026:Ligation / Q000295:instrumentation; D008210:Lymphocele / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010537:Peritoneum / Q000601:surgery; D012189:Retrospective Studies; D055502:Secondary Prevention