Skip to main content
SpringerLink
Log in

Laparoscopic treatment of post renal transplant lymphoceles

  • Original article
  • Published:
Surgical Endoscopy And Other Interventional Techniques Aims and scope Submit manuscript

Abstract

Background: Traditionally, a post transplant lymphocele (PTL) is drained by widely opening the wall connecting the lymphocele cavity to the intraperitoneal space via laparotomy. We hypothesize that laparoscopic techniques can be effectively used for the treatment of PTL.Methods: Patients requiring intervention for PTL between 1993 and 2002 were identified via a retrospective review. Results of drainage via laparotomy and laparoscopy were compared.Results: During the study period 685 renal transplants (391 cadaveric, 294 living) were performed. The incidence of lymphocele was 5% [34/685 (36 cases)]. The indications for surgical drainage were local symptoms (69%), graft dysfunction (14%), or both (17%). The mean time to surgical therapy was 4.9 months. Laparoscopic drainage was performed in 25 patients (74%) and open drainage in 9 patients (26%). Open procedures were performed in cases for: previous abdominal surgery (5), undesirable lymphocele characteristics or location (2), or with concomitant open procedures (3). There were no conversions or operative complications in either group. There was no difference in operative time for the laparoscopic group vs the open group (108 ± 6 vs 123 ± 18 min, p = 0.8). Hospital stay was significantly shorter for the laparoscopic group (1.7 ± 0.8 vs 3.8 ± 1.0, p = 0.0007), with 88% of laparoscopic patients being either overnight admissions or same day surgery. Two patients (5%) developed symptomatic recurrences requiring reoperation [1 laparoscopic (4%), 1 open (10%)].Conclusions: Laparoscopic fenestration of a peritransplant lymphocele is a safe and effective treatment. The large majority of patients treated with laparoscopic fenestration were discharged within one day of surgery. Unless contraindications exist, laparoscopy should be considered first-line therapy for the surgical treatment of posttransplant lymphocele.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. WE Braun LH Banowsky RA Straffon S Nakamoto WS Kiser KL Popowniak CB Hewitt BH Stewart JV Zelch RL Magalhaes JG Lachance RF Manning (1974) ArticleTitleLymphoceles associated with renal transplantation: report of 15 cases and review of the literature. Am J Med 57 714–729 Occurrence Handle1:STN:280:CSqD2s%2FpsVQ%3D Occurrence Handle4613172

    CAS  PubMed  Google Scholar 

  2. FJ Burgos JL Teruel T Mayayo F Lovaco A Berenguer L Orte M Tallada J Ortuno (1988) ArticleTitleDiagnosis and management of lymphoceles after renal transplantation. Br J Urol 61 289–293 Occurrence Handle1:STN:280:BieB2M3mt1A%3D Occurrence Handle3289674

    CAS  PubMed  Google Scholar 

  3. R Cadrobbi G Zaninotto P Rigotti N Baldan G Sarzo E Ancona (1999) ArticleTitleLaparoscopic treatment of lymphocele after transplantation. Surg Endosc 13 985–990 Occurrence Handle1:STN:280:DyaK1MvlslGiug%3D%3D Occurrence Handle10526032

    CAS  PubMed  Google Scholar 

  4. C Doehn P Fornara L Fricke D Jocham (2002) ArticleTitleLaparoscopic fenestration of posttransplant lymphoceles. . 16 690–695 Occurrence Handle10.1007/s00464-001-9150-2 Occurrence Handle1:STN:280:DC%2BD383jsVCjsw%3D%3D

    Article  CAS  Google Scholar 

  5. BM Greenberg LJ Perloff RA Grossman A Naji CF Barker (1985) ArticleTitleTreatment of lymphocele in renal allograft recipients. Arch Surg 120 501–504 Occurrence Handle1:CAS:528:DyaL2sXitVCls7g%3D Occurrence Handle3885913

    CAS  PubMed  Google Scholar 

  6. RJ Howard RL Simmons JS Najarian (1976) ArticleTitlePrevention of lymphoceles following renal transplantation. Ann Surg 184 166–168 Occurrence Handle1:STN:280:CSmB2M7nvFM%3D Occurrence Handle782387

    CAS  PubMed  Google Scholar 

  7. DM Hume (1968) Kidney transplantation. FT Rapaport JCh Dausset (Eds) Human transplantation Grune & Stratton New York 110–150

    Google Scholar 

  8. TH Hsu IS Gill MT Grune R Andersen D Eckhoff DA Goldfarb R Gruessner EE Hodge LC Munch DD Nghiem A Nye CR Reckard T Shaver RJ Stratta RJ Taylor (2000) ArticleTitleLaparoscopic lymphocelectomy: a multi-institutional analysis. J Urol 163 1096–1099 Occurrence Handle1:STN:280:DC%2BD3c7pvFOgtg%3D%3D Occurrence Handle10737473

    CAS  PubMed  Google Scholar 

  9. RK Jr Kerlan JM LaBerge RL Gordon EJ Ring (1997) ArticleTitleBleomycin sclerosis of pelvic lymphoceles. J Vasc Interv Radiol 8 885–887 Occurrence Handle9314383

    PubMed  Google Scholar 

  10. K Kuzuhara S Inoue Y Dobashi K Fujita O Otsubo T Inou Y Matushita H Katori K Yokoyama Y Ubara H Hinoshita F Takemoto S Kara A Yamada N Mimura (1997) ArticleTitleEthanol ablation of lymphocele after renal transplantation: A minimally invasive approach. Transplant Proc 29 147–150 Occurrence Handle10.1016/S0041-1345(96)00042-5 Occurrence Handle1:STN:280:ByiB3s%2FltlE%3D Occurrence Handle9122936

    Article  CAS  PubMed  Google Scholar 

  11. V Lange HM Schardey G Meyer WD Illner P Petersen W Land (1994) ArticleTitleLaparoscopic deroofing of post-transplant lymphoceles. Transpl Int 7 140–143 Occurrence Handle1:STN:280:ByuB3srhtl0%3D Occurrence Handle8179803

    CAS  PubMed  Google Scholar 

  12. RM Langer BD Kahan (2002) ArticleTitleIncidence, therapy, and consequences of lymphocele after sirolimus-cyclosporine-prednisone immunosuppression in renal transplant recipients. Transplantation 74 804–808 Occurrence Handle1:CAS:528:DC%2BD38XnsFOltro%3D Occurrence Handle12364859

    CAS  PubMed  Google Scholar 

  13. F Längle H Schurawitzki F Mühlbacher R Steininger B Watschinger K Derfler F Stockenhuber F Piza (1990) ArticleTitleTreatment of lymphoceles following renal transplantation. Transplant Proc 22 1420–1422 Occurrence Handle2389347

    PubMed  Google Scholar 

  14. M Malovrh A Kandus J Buturovic-Ponikvar J Lindic B Knap D Fliser J Drinovec (1990) ArticleTitleFrequency and clinical influence of lymphoceles after kidney transplantation. Transplant Proc 22 1423–1424 Occurrence Handle1:STN:280:By%2BA2MjktFM%3D Occurrence Handle2202117

    CAS  PubMed  Google Scholar 

  15. RC Manfro L Comerlato RH Berdichevski AR Ribeiro NT Denicol M Berger D Saitovitch WJ Koff LF Goncalves (2002) ArticleTitleNephrotoxic acute renal failure in a renal transplant patient with recurrent lymphocele treated with povidone-iodine irrigation. Am J Kidney Dis 40 655–657 Occurrence Handle10.1053/ajkd.2002.34930 Occurrence Handle12200820

    Article  PubMed  Google Scholar 

  16. JC Martinez-Ocana R Lauzurica E Castellote J Bonet M Tenesa JA Jimenez JM Saladie A Caralps (1995) ArticleTitleAdult polycystic kidney disease: a risk factor for lymphocele formation after renal transplantation?. Transplant Proc 27 2246–2247 Occurrence Handle1:STN:280:ByqA1c7ivVM%3D Occurrence Handle7652792

    CAS  PubMed  Google Scholar 

  17. CS McCullough NJ Soper RV Clayman SS So MD Jendrisak DW Hanto (1991) ArticleTitleLaparoscopic drainage of a posttransplant lymphocele. Transplantation 51 725–727 Occurrence Handle1:STN:280:By6C2szltFY%3D Occurrence Handle2006532

    CAS  PubMed  Google Scholar 

  18. R Pollak SA Veremis MS Maddux MF Mozes (1988) ArticleTitleThe natural history of and therapy for perirenal fluid collections following renal transplantation. J Urol 140 716–720 Occurrence Handle1:STN:280:BieA3szhvVQ%3D Occurrence Handle3047434

    CAS  PubMed  Google Scholar 

  19. A Risaliti V Corno A Donini N Cautero U Baccarani A Pasqualucci G Terrosu C Cedolini F Bresadola (2000) ArticleTitleLaparoscopic treatment of symptomatic lymphoceles after kidney transplantation. Surg Endosc 14 293–295 Occurrence Handle10.1007/s004640000062 Occurrence Handle1:STN:280:DC%2BD3c3gtlCqtA%3D%3D Occurrence Handle10741452

    Article  CAS  PubMed  Google Scholar 

  20. CV Sansalone P Aseni E Minetti F Di Benedetto O Rossetti F Manoochehri M Vertemati A Giacomoni G Civati D Forti (2000) ArticleTitleIs lymphocele in renal transplantation an avoidable complication?. Am J Surg 179 182–185 Occurrence Handle1:STN:280:DC%2BD3c3oslaqtA%3D%3D Occurrence Handle10827314

    CAS  PubMed  Google Scholar 

  21. M Schilling D Abendroth R Kunz (1995) ArticleTitleTreatment of lymphocele in renal transplant recipients by laparoscopic fenestration after transcutaneous staining. Br J Surg 82 246–248 Occurrence Handle1:STN:280:ByqB28fnvVY%3D Occurrence Handle7538413

    CAS  PubMed  Google Scholar 

  22. AA Shokeir I Eraky H el-Kappany MA Ghoneim (1994) ArticleTitleAccidental division of the transplanted ureter during laparoscopic lymphocele drainage of lymphocele. J Urol 151 1623–1625 Occurrence Handle1:STN:280:ByuB2cnotVA%3D Occurrence Handle8189579

    CAS  PubMed  Google Scholar 

  23. E Stephanian AJ Matas P Gores DE Sutherland JS Najanrian (1992) ArticleTitleRetransplantation as a risk factor for lymphocele formation. Transplantation 53 676–678 Occurrence Handle1:STN:280:By2C1MnovFI%3D Occurrence Handle1549865

    CAS  PubMed  Google Scholar 

  24. JL Teruel EM Escobar C Quereda T Mayayo J Ortuno (1983) ArticleTitleA simple and safe method for management of lymphocele after renal transplantation. J Urol 130 1058–1059 Occurrence Handle1:STN:280:BiuD28vps1c%3D Occurrence Handle6358528

    CAS  PubMed  Google Scholar 

  25. ML Tie MM Rao C Russell K Burapa (2001) ArticleTitleTransperitoneal guide-wire or drainage catheter placement for guidance of laparoscopic marsupialization of lymphoceles post renal transplantation. Nephrol Dial Transplant 16 1038–1041 Occurrence Handle10.1093/ndt/16.5.1038 Occurrence Handle1:STN:280:DC%2BD3Mzotleguw%3D%3D Occurrence Handle11328913

    Article  CAS  PubMed  Google Scholar 

  26. K Ward WC Klingensmith 3rd S Sterioff HN Jr Wagner (1978) ArticleTitleThe origin of lymphoceles following renal transplantation. Transplantation 25 346–347 Occurrence Handle1:STN:280:CSeB3crhslQ%3D Occurrence Handle351898

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, University of Utah, 30 North 1900 East, 3B 322 School of Medicine, Salt Lake City, UT, 84132, USA

    S. H. Bailey, M. C. Mone, J. M. Holman & E. W. Nelson

Authors
  1. S. H. Bailey
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. C. Mone
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. M. Holman
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. E. W. Nelson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to E. W. Nelson.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bailey, S., Mone, M., Holman, J. et al. Laparoscopic treatment of post renal transplant lymphoceles . Surg Endosc 17, 1896–1899 (2003). https://doi.org/10.1007/s00464-003-8814-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-003-8814-5

Keywords

Search

Navigation