title: Laparoscopic fenestration versus percutaneous catheter drainage for lymphocele treatment after kidney transplantation.
abstract: BACKGROUND
  Laparoscopic fenestration (LF) and percutaneous catheter drainage (PCD) are widely accepted treatments for symptomatic lymphoceles. The aim of this study was to review the results and compare the outcomes of LF with those of PCD.
  
  
  METHODS
  Among 1363 patients who underwent kidney transplantation at our institute between 1999 and 2011, 35 (2.5%) developed symptomatic lymphoceles. Among them, 7 were treated by LF after PCD; 10, LF only, and 18 PCD only. The patients were divided into 2 groups based upon the treatment method: LF (n = 17) and PCD-only groups (n = 18).
  
  
  RESULTS
  No intergroup differences in age, gender, diabetes prevalence, retransplant rate, delayed graft function, or serum creatinine was observed at 7 days after the treatment. However, acute rejection episodes and sirolimus use were more frequent among the LF group (P = .028). Furthermore, median drainage on the first day was significantly greater in the LF versus PCD group. After catheter insertion, the PCD group showed a significant decrease in drainage on the following day, but no decrease was observed in the LF group.
  
  
  CONCLUSIONS
  LF is a safe treatment for symptomatic lymphocele. LF should be held in reserve for treatment failures after PCD. LF seems to be a more reasonable first-line treatment for symptomatic lymphoceles in patients at high risk for graft dysfunction.
authors.affiliation: Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: H S
authors.initials: HS
authors.lastname: Lee
authors.forename: D J
authors.initials: DJ
authors.lastname: Joo
authors.forename: K H
authors.initials: KH
authors.lastname: Huh
authors.forename: M S
authors.initials: MS
authors.lastname: Kim
authors.forename: S I
authors.initials: SI
authors.lastname: Kim
authors.forename: Y S
authors.initials: YS
authors.lastname: Kim
authors.forename: W J
authors.initials: WJ
authors.lastname: Lee
mesh_terms: D000328:Adult; D002408:Catheters, Indwelling; D004322:Drainage; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D010535:Laparoscopy; D008210:Lymphocele / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D055815:Young Adult