Sibert L, Descargues G, Etienne I, Annoot M, Boillot B, Grise P
Service d'Urologie, Hôpital Charles Nicolle, C.H.U., Rouen.
Prog Urol. 1993 Aug-Sep;3(4):671-6.
The authors report a case of transperitoneal laparoscopic drainage of a recurrent, compressive lymphocele occurring 3 months after cadaver renal transplantation. The technique consists of creating a transperitoneal breach and resecting the walls of the lymphocele to ensure internal drainage followed by suture of a slip of greater omentum over the opened lymphatic cavity. Preoperative aspiration and computed tomography precisely defined the site of the lymphocele in relation to urinary and vascular structures, confirmed the lymphatic nature of the collection and excluded the presence of infection. This technique has the same indications as classical surgical internal drainage and can be used to easily perform the same procedures. Because of its simplicity and low morbidity, laparoscopic drainage can be proposed as first-line treatment for large, symptomatic and recurrent posttransplantation lymphoceles, in the absence of infection and provided the lymphocele is in an accessible site and the operator has a sufficient experience of laparoscopic techniques.
作者报告了一例尸体肾移植3个月后发生的复发性压迫性淋巴管瘤经腹腔腹腔镜引流的病例。该技术包括制造一个经腹腔的开口并切除淋巴管瘤的壁以确保内引流，随后将大网膜的一片缝合在开放的淋巴腔上。术前抽吸和计算机断层扫描精确地确定了淋巴管瘤相对于泌尿系统和血管结构的位置，证实了积液的淋巴性质并排除了感染的存在。该技术与传统手术内引流具有相同的适应证，并且可以轻松地用于执行相同的操作。由于其简单性和低发病率，在没有感染且淋巴管瘤位于可及部位且操作者有足够腹腔镜技术经验的情况下，腹腔镜引流可作为大型、有症状且复发性移植后淋巴管瘤的一线治疗方法。
