Document Detail


Did volume of lymphocele after kidney transplantation determine the choice of treatment modality?
MedLine Citation:
PMID:  18021974     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Lymphocele is a lymph collection that forms after surgery following injury to lymph nodes and vessels. The aim of the study was to perform a retrospective analysis of different treatment modalities of lymphocele in patients after kidney transplantation. MATERIAL AND METHODS: A lymphocele located in renal graft area was observed in 25 of 386 transplanted patients (6.5%). Mean patient age was 45 (95% confidence interval [CI], 40 to 50) years. Mean observation time was 35 (95% CI, 27 to 43) months. RESULTS: Mean time from transplantation to diagnosis of lymphocele was 29 days (range, 4 to 127). In 13 patients (54.2%), the lymphocele was symptomatic, requiring initial treatment by repeated needle aspirations or percutaneous drainage. Among 7 patients with persistence of the lesion treatment by sclerotherapy with doxycycline, povidone-iodine, and/or ethanol was successful in 4 cases who showed maximal lymphocele volume of 500 mL. Three other patients, namely, volumes of 120, 874, and 2298 mL were referred for surgery; in two cases, internal marsupialization was performed and in one case external drainage was necessary due to abscess formation. Mean time from the diagnosis to recovery in patients requiring surgical treatment was 15 (range, 8 to 24) weeks. Eleven patients with asymptomatic lymphoceles (mean volume 45 mL; range, 8 to 140) were monitored to resolution after a mean of 4 (range, 1 to 11) weeks. CONCLUSION: All lymphoceles with the maximal volume exceeding 140 mL were clinically symptomatic. Initial percutaneous drainage with or without sclerotherapy was an effective method of treatment. Punctures, drainage, and sclerotherapy were not effective in patients with lymphoceles (>500 mL).
Authors:
R Król; A Kolonko; J Chudek; J Ziaja; J Pawlicki; A Mały; A Kunsdorf-Wnuk; L Cierpka; A Wiecek
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Transplantation proceedings     Volume:  39     ISSN:  0041-1345     ISO Abbreviation:  Transplant. Proc.     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-11-20     Completed Date:  2008-01-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0243532     Medline TA:  Transplant Proc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2740-3     Citation Subset:  IM    
Affiliation:
Department of General, Vascular and Transplant Surgery, Katowice, Poland. robertk@hot.pl
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MeSH Terms
Descriptor/Qualifier:
Adult
Biopsy, Needle
Cadaver
Doxycycline / therapeutic use
Ethanol / therapeutic use
Follow-Up Studies
Humans
Kidney Transplantation / adverse effects*
Living Donors
Lymphocele / drug therapy,  epidemiology,  etiology*,  pathology*
Middle Aged
Postoperative Complications / drug therapy,  epidemiology,  pathology*
Povidone-Iodine / therapeutic use
Retrospective Studies
Sclerotherapy
Time Factors
Tissue Donors
Chemical
Reg. No./Substance:
25655-41-8/Povidone-Iodine; 564-25-0/Doxycycline; 64-17-5/Ethanol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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