Document Detail


Laparoscopic drainage of lymphoceles after kidney transplantation: indications and limitations.
MedLine Citation:
PMID:  7878535     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Symptomatic lymphoceles are not uncommon after kidney transplantations. Surgical marsupialization with internal drainage is the treatment of choice. However, laparoscopic drainage is reportedly as effective, with only minimal trauma. METHODS: We attempted 14 laparoscopic lymphocele drainages during a 3-year period and studied the indications and limitations, using intraoperative ultrasonography in all cases. RESULTS: Laparoscopic drainage was successful in only 9 (64%) of 14 patients. A conversion to open laparotomy was necessary in five patients; their lymphoceles were lateral and either posterior or inferior to the kidney. Two patients with initially successful laparoscopic drainage required conversion to open laparotomy 21 and 83 days later; their lymphoceles were inferior to the kidney. Laparoscopic drainage shortened the median hospital stay by 4 days versus open surgical drainage and by 7 days versus conversion. Hospital costs for laparoscopic drainage averaged $7400 less versus open drainage and $10,300 less versus conversion. CONCLUSIONS: In patients with symptomatic lymphoceles medial and either superior or anterior to the kidney, laparoscopic drainage under intraoperative ultrasonographic guidance is easy, safe, and effective. It decreases hospitalization, convalescence, and costs. In patients with symptomatic lymphoceles lateral and either posterior or inferior to the kidney, laparoscopic drainage may fail because of anatomic inaccessibility and technical impracticability.
Authors:
R W Gruessner; C Fasola; E Benedetti; M C Foshager; A C Gruessner; A J Matas; J S Najarian; R L Goodale
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Surgery     Volume:  117     ISSN:  0039-6060     ISO Abbreviation:  Surgery     Publication Date:  1995 Mar 
Date Detail:
Created Date:  1995-04-04     Completed Date:  1995-04-04     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  288-95     Citation Subset:  AIM; IM    
Affiliation:
University of Minnesota, Department of Surgery, Minneapolis 55455.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Drainage / economics,  methods*
Female
Hospital Costs
Humans
Kidney Diseases / etiology,  therapy*,  ultrasonography
Kidney Transplantation / adverse effects*
Laparoscopy
Length of Stay / economics
Lymphocele / etiology,  therapy*,  ultrasonography
Male
Middle Aged
Treatment Outcome

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


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