Lymphocele after kidney transplantation.
BACKGROUND
One of the most often occurring complications after a kidney transplantation is a lymphocele.


METHODS
The examined group consisted of 118 patients (70 males and 48 females) with end-stage renal disease (ESRD).


RESULTS
Fourteen patients (12%) developed symptoms of lymphocele within an average time of 34 weeks. The clinical symptoms included the following: decreased 24-hour urine collection and increased creatinine level, abdominal discomfort, lymphorrhoea with surgical wound dehiscence, urgency, vesical tenesmus, and/or fever. Increased appearance of lymphocele was noticed in patients with diabetic nephropathy, congenital malformations of the urinary tract, and inflammatory diseases, including glomerulopathy and extraglomerular ones, after high-voltage radiotherapy and after removal of the renal graft. The methods of treatment and their efficacy were as follows: percutaneous aspiration with the ratio of recurrence 100%; ultrasound guided percutaneous drainage 50%; laparoscopic intraabdominal marsupialization 75%; and surgical intervention with favorable results.


CONCLUSIONS
Ultrasound-guided percutaneous drainage with a success rate greater than 50% should be recommended as the first line of treatment. As a minimal invasive surgery this kind of treatment does not interfere with subsequent internal drainage through an open or a laparoscopic surgery. Laparoscopy, a feasible, safe technique with a success rate of more than 80%, should be used routinely after unsuccessful percutaneous drainage.
Zietek
Z
Z
Department of the General Surgery and Transplantology, Pomerenian Medical Academy, Szczecin, Poland. zzietek@poczta.onet.pl
Sulikowski
T
T
Tejchman
K
K
Sieńko
J
J
Janeczek
M
M
Iwan-Zietek
I
I
Kedzierska
K
K
Rość
D
D
Ciechanowski
K
K
Ostrowski
M
M
D003928:Diabetic Nephropathies / Q000150:complications / Q000601:surgery; D004322:Drainage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects*; D010535:Laparoscopy; D008210:Lymphocele / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy; D008297:Male; D010146:Pain; D012189:Retrospective Studies; D013997:Time Factors