Schiavone A, Scarone P C, Guaitoli S
Scuola di Specializzazione in Chirurgia d'Urgenza, Università degli Studi, Modena, Italy.
Minerva Chir. 2002 Apr;57(2):225-7.
Personal experience in the laparoscopic treatment of a lymphocele following kidney transplantation and a review of the literature are presented. We have treated a symptomatic lymphocele, which occurred a month after renal transplantation. It compressed the iliac vessels and obstructed the urine flow. Physical examinations revealed it consisted of two chambers; it measured 12 x 8 x 6 cm. A US-guided puncture was performed and a drainage tube out in place. A continuous flow of lymphatic liquid derived, and therefore we decided on surgical intervention, which was conducted in laparoscopy. A puncture of blue through the drainage tube was performed; under US-guidance, we made an opening in the peritoneal wall and in the wall of the lymphocele. A cauterization of the edges was conducted. An immediate improvement in subjective and objective symptoms was achieved. A four-month follow-up showed minimal residual effusion, slowly disappearing. Literature data and clinical evolution of the patient show that the laparoscopic approach is to be considered the "gold standard" for the treatment of symptomatic lymphocele following kidney transplantation. The authors recommend the use of US-guidance to single out anatomic structures, particularly for surgeons not trained in this procedure.
本文介绍了肾移植后腹腔镜治疗淋巴囊肿的个人经验并对相关文献进行了综述。我们治疗了一例肾移植术后1个月出现的症状性淋巴囊肿。它压迫了髂血管并阻碍了尿液流动。体格检查发现它由两个腔室组成，大小为12×8×6厘米。进行了超声引导下穿刺并留置了引流管。有持续的淋巴液流出，因此我们决定进行手术干预，采用腹腔镜手术。通过引流管进行蓝色穿刺；在超声引导下，我们在腹膜壁和淋巴囊肿壁上开口。对边缘进行了烧灼。主观和客观症状立即得到改善。四个月的随访显示残留积液极少，且正在缓慢消失。文献数据和患者的临床进展表明，腹腔镜手术应被视为肾移植后症状性淋巴囊肿治疗的“金标准”。作者建议使用超声引导来识别解剖结构，特别是对于未接受过该手术培训的外科医生。
