Division of Urology, Department of Surgery, State University of Campinas-UNICAMP, Campinas, Sao Paulo, Brazil.
Int Braz J Urol. 2012 Mar-Apr;38(2):215-21; discussion 221. doi: 10.1590/s1677-55382012000200009.
Lymphocele formation following renal transplantation is a frequent complication and may affect as many as 49% of patients. Operative treatment of symptomatic post transplant lymphocele (PTL) consists of wide drainage of the fluid collection into the abdominal cavity by excising its wall, connecting the lymphocele cavity to the intraperitoneal space. Laparoscopic fenestration seems to be the best treatment as it combines satisfying success rates with a minimally invasive approach. The aim of the study was to review a single center experience on the laparoscopic treatment of symptomatic PTL and detail relevant aspects of the surgical technique.
The data of 25 patients who underwent laparoscopic surgical treatment for a symptomatic lymphocele following kidney transplantation were retrospectively reviewed. Demographic data and surgical results were assessed. Detailed surgical technique is provided.
Between 1996 and 2008, 991 patients received a kidney transplant at our institution. Twenty-five patients (2.52%) developed a symptomatic lymphocele and laparoscopic drainage was performed. The indications for surgical drainage were graft dysfunction (84%), local symptoms (16%) or both (32%). The mean time until surgical therapy was 14.2 ± 6 weeks. Mean hospital stay was 1.5 ± 0.2 days. Postoperative complications occurred in only 2 patients (8%) (one ureteral injury and one incisional hernia) and required reoperation. After a mean followup of 36.2 ± 4 months, only 1 patient had a symptomatic recurrence.
Laparoscopic fenestration is an effective surgical technique to treat symptomatic lymphocele following kidney transplantation with low recurrence rate and long standing results.
肾移植后淋巴囊肿的形成是一种常见的并发症，多达 49%的患者可能受到影响。手术治疗症状性移植后淋巴囊肿（PTL）包括切除囊肿壁以将液体广泛引流到腹腔中，并将淋巴囊肿腔与腹腔内空间连接起来。腹腔镜开窗术似乎是最好的治疗方法，因为它结合了令人满意的成功率和微创方法。本研究的目的是回顾单中心在腹腔镜治疗症状性 PTL 方面的经验，并详细介绍手术技术的相关方面。
回顾性分析了 25 例因肾移植后出现症状性淋巴囊肿而行腹腔镜手术治疗的患者的资料。评估了人口统计学数据和手术结果。提供了详细的手术技术。
1996 年至 2008 年期间，我院共为 991 例患者进行了肾移植。25 例（2.52%）患者出现症状性淋巴囊肿，行腹腔镜引流术。手术引流的指征是移植物功能障碍（84%）、局部症状（16%）或两者兼有（32%）。手术治疗的平均时间为 14.2±6 周。平均住院时间为 1.5±0.2 天。仅 2 例（8%）患者发生术后并发症（1 例输尿管损伤和 1 例切口疝），需要再次手术。平均随访 36.2±4 个月后，仅 1 例患者出现症状性复发。
腹腔镜开窗术是治疗肾移植后症状性淋巴囊肿的有效手术技术，复发率低，长期效果好。
