[Preventive use of pedicled omentum majus within the scope of kidney transplantation].

The interposition of the greater omentum was used for treatment of lymphoceles in combination with peritoneal fenestration and for prevention of urinary fistulas in cases of lower pole renal artery lesions and feared ureteral necrosis as well as for protection of pyeloureterostomics and pyelovesicostomics, secondary to ureteral necrosis postrenal transplantation. Especially the combination of peritoneum fenestration with interposition of the greater omentum proved to be the procedure of choice for treatment of posttransplant lymphoceles. The incidence of lymphoceles following renal transplantation is in the range of 5-15%. Even by meticulous surgical technique--ligature of donor and recipient lymph vessels--they cannot be prevented totally since perioperative anticoagulation plays a significant role. Following unsuccessful repeated punctures for decompression, external drainage, local application of tetracycline or fibrinogen glue, internal marsupialisation to the peritoneal cavity is the established ultimate treatment. Inherent risks and difficulties of this procedure can be reduced, if peritoneal fenestration of the lymphoceles is combined with the interposition of the greater omentum. This technique described in details gave totally satisfactory results in 14 cases.