Ishitani M B, DeAngelis G A, Sistrom C L, Rodgers B M, Pruett T L
Department of Surgery, University of Virginia Health Sciences Center, Charlottesville.
J Laparoendosc Surg. 1994 Feb;4(1):61-4. doi: 10.1089/lps.1994.4.61.
The development of a lymphocele is an uncommon but well-documented complication of renal transplantation. In most patients, lymphoceles remain asymptomatic, and no intervention is required. In some cases, however, lymphoceles become symptomatic and cause systemic and local manifestations. Ultrasonic scanning can easily diagnose and locate the size and position of perirenal fluid collections. Many of these patients can be managed conservatively by aspiration and drainage of the lymphocele under radiologic guidance. However, if the lymphocele remains symptomatic or reaccumulates after aspiration and drainage, surgical intervention may be required. We describe two different ultrasound-guided laparoscopic techniques for drainage of a perirenal lymphocele into the peritoneal cavity. Successful drainage was accomplished in 5 patients, with 1 patient suffering an injury to the ureter of the transplant kidney. Recommendations regarding patient selection and operative technique are presented.
淋巴管囊肿是肾移植术后一种罕见但有充分文献记载的并发症。大多数患者的淋巴管囊肿无症状，无需干预。然而，在某些情况下，淋巴管囊肿会出现症状并引起全身和局部表现。超声扫描可轻松诊断并定位肾周液体积聚的大小和位置。许多此类患者可通过在放射学引导下对淋巴管囊肿进行抽吸和引流来保守治疗。然而，如果淋巴管囊肿仍有症状或在抽吸和引流后再次积聚，则可能需要手术干预。我们描述了两种不同的超声引导下腹腔镜技术，用于将肾周淋巴管囊肿引流至腹腔。5例患者成功完成引流，1例患者移植肾输尿管受损。文中还给出了关于患者选择和手术技术的建议。
