title: Laparoscopic treatment of lymphoceles after renal transplantation.
abstract: OBJECTIVE
  Lymphocele formation following renal transplantation is a frequent complication and may affect as many as 49% of patients. Operative treatment of symptomatic post transplant lymphocele (PTL) consists of wide drainage of the fluid collection into the abdominal cavity by excising its wall, connecting the lymphocele cavity to the intraperitoneal space. Laparoscopic fenestration seems to be the best treatment as it combines satisfying success rates with a minimally invasive approach. The aim of the study was to review a single center experience on the laparoscopic treatment of symptomatic PTL and detail relevant aspects of the surgical technique.
  
  
  METHODS
  The data of 25 patients who underwent laparoscopic surgical treatment for a symptomatic lymphocele following kidney transplantation were retrospectively reviewed. Demographic data and surgical results were assessed. Detailed surgical technique is provided.
  
  
  RESULTS
  Between 1996 and 2008, 991 patients received a kidney transplant at our institution. Twenty-five patients (2.52%) developed a symptomatic lymphocele and laparoscopic drainage was performed. The indications for surgical drainage were graft dysfunction (84%), local symptoms (16%) or both (32%). The mean time until surgical therapy was 14.2 ± 6 weeks. Mean hospital stay was 1.5 ± 0.2 days. Postoperative complications occurred in only 2 patients (8%) (one ureteral injury and one incisional hernia) and required reoperation. After a mean followup of 36.2 ± 4 months, only 1 patient had a symptomatic recurrence.
  
  
  CONCLUSIONS
  Laparoscopic fenestration is an effective surgical technique to treat symptomatic lymphocele following kidney transplantation with low recurrence rate and long standing results.
authors.affiliation: Division of Urology, Department of Surgery, State University of Campinas-UNICAMP, Campinas, Sao Paulo, Brazil.
authors.forename: Marcelo Lopes de
authors.initials: ML
authors.lastname: Lima
authors.forename: Cristiano Augusto Calderaro
authors.initials: CA
authors.lastname: Cotrim
authors.forename: Juliano Cesar
authors.initials: JC
authors.lastname: Moro
authors.forename: Ricardo
authors.initials: R
authors.lastname: Miyaoka
authors.forename: Carlos Arturo Levi
authors.initials: CA
authors.lastname: D'Ancona
mesh_terms: D000328:Adult; D004322:Drainage; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D010535:Laparoscopy / Q000379:methods*; D008210:Lymphocele / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D059035:Perioperative Period; D016896:Treatment Outcome