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[肾移植术后淋巴管囊肿的腹腔镜开窗术]

[Laparoscopic fenestration of lymphoceles after kidney transplantation].

作者信息

Stencl J, Bujdák P, Miklosi M, Breza J, Reznícek J

机构信息

Chirurgická klinika SPAM, FNsP L. Dérera, Bratislava.

出版信息

Rozhl Chir. 2001 Jun;80(6):311-4.

Abstract

Lymphocele is a relatively frequent complication after kidney transplantation, which impair the passage of urine from the kidney, cause emptying of bladder lymphoedemas of the lower limbs, etc. Percutaneous drainage of lymphocele is associated with a risk of infection and a high percentage of recurrence. Until recently, standard surgical treatment of this complication was open fenestration of the lymphocele into the peritoneal cavity. In their paper, the authors describe their first experience with laparoscopic fenestration of the lymphocele. From May 1998 till April 1999 the authors performed laparoscopic fenestration in 5 patients. In four patients the intervention was successful, in one female patient recurrence of lymphocele was observed, which was later resolved by an open operation. In none of the patients early or late surgical complications occurred, the use of analgetics during the postoperative period was minimal, the length of hospitalisation ranged from 2 to 4 days. The authors consider the discussed method a suitable alternative for treating lymphocele after renal transplantation thanks to its minimal invasivity. It involves practically no load of the sick patients after kidney transplantation.

摘要

淋巴囊肿是肾移植后相对常见的并发症,它会妨碍尿液从肾脏排出,导致膀胱排空障碍、下肢淋巴水肿等。经皮引流淋巴囊肿存在感染风险且复发率较高。直到最近,这种并发症的标准外科治疗方法是将淋巴囊肿开放开窗至腹腔。在他们的论文中,作者描述了他们首次进行腹腔镜下淋巴囊肿开窗术的经验。从1998年5月至1999年4月,作者对5例患者进行了腹腔镜开窗术。4例患者手术成功,1例女性患者出现淋巴囊肿复发,后来通过开放手术解决。所有患者均未发生早期或晚期手术并发症,术后镇痛药物的使用极少,住院时间为2至4天。作者认为,由于其微创性,所讨论的方法是肾移植后治疗淋巴囊肿的合适替代方法。它对肾移植后的患病患者几乎不造成负担。

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