title: Does ultrasonic energy for surgical dissection reduce the incidence of renal transplant lymphocele?
abstract: OBJECTIVE
  To determine the difference in post-renal transplant lymphocele rate based on the surgical dissection technique for control of lymphatics by examining the historical case group under the direction of a single, university-based surgeon in a retrospective, cohort study.
  
  
  METHODS
  Five hundred thirty-two consecutive renal transplant patients from January 1994 to December 2009.
  
  
  RESULTS
  Of the 532 cases studied, 259 (48.7%) had suture ligation and 273 (51.3%) employed ultrasonic dissection (UD) for control of lymphatics during renal transplantation. There was no difference found in the rate of lymphocele formation, requiring either percutaneous or surgical drainage, when surgical ties (8.9%) were compared to UD (9.2%; P=.999). Logistic regression analysis showed that the odds ratio for developing a lymphocele was independent of surgical dissection technique. Within the logistic analysis, the prediction for lymphocele was increased 3.29 times for pediatric patients (P=.002) and increased 2.97 times for those who received a living donor graft (P=.001), and there was a trend for those with a history of more than one renal transplant of 2.01 times (P=.079).
  
  
  CONCLUSIONS
  Surgical dissection technique was not a factor in the development of post-renal transplant lymphocele. Younger age, living donor transplant, and repeat transplant status were found to be predictive variables for symptomatic lymphoceles requiring drainage, which may be considered when patients present for posttransplant evaluations for laboratory alterations.
authors.affiliation: Department of Surgery, University of Utah, Salt Lake City, Utah 84132, USA. edward.nelson@hsc.utah.edu
authors.forename: E W
authors.initials: EW
authors.lastname: Nelson
authors.forename: M E
authors.initials: ME
authors.lastname: Gross
authors.forename: M C
authors.initials: MC
authors.lastname: Mone
authors.forename: H J
authors.initials: HJ
authors.lastname: Hansen
authors.forename: X
authors.initials: X
authors.lastname: Sheng
authors.forename: K M
authors.initials: KM
authors.lastname: Cannon
authors.forename: S
authors.initials: S
authors.lastname: Alder
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D016009:Chi-Square Distribution; D002648:Child; D004210:Dissection / Q000379:methods*; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008026:Ligation; D019520:Living Donors; D016015:Logistic Models; D042601:Lymphatic Vessels / Q000601:surgery*; D008210:Lymphocele / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D059708:Ultrasonic Surgical Procedures; D014589:Utah; D055815:Young Adult