Laparoscopic treatment of lymphoceles after renal transplantation

Lima, Marcelo Lopes de; Cotrim, Cristiano Augusto Calderaro; Moro, Juliano César; Miyaoka, Ricardo; D’Ancona, Carlos Arturo Levi

doi:10.1590/s1677-55382012000200009

Cited by 27 publications

(19 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The therapeutic options include interventional radiology procedures (simple aspiration, image‐guided percutaneous catheter drainage with or without sclerotherapy), and surgical treatment (open or laparoscopic fenestration). Fenestration as marsupialization of the lymph collection into the peritoneal cavity by creating an internal drainage is considered the therapy of choice by many authors . This technique is also used for management of lymphatic collections following pelvic surgery .…”

Section: Introductionmentioning

confidence: 99%

“…Finally, peritoneal fenestration at the time of KTx has been proposed as a simple surgical method to prevent lymphocele formation. Peritoneal fenestration is widely used to treat lymphoceles following KTx ; however, is used as prophylactic measure ; and is less well described. The aim of this study was therefore to evaluate the benefits and harms of prophylactic fenestration of the peritoneal cavity in KTx based on the current literature.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prophylaxis of lymphocele formation after kidney transplantation via peritoneal fenestration: a systematic review

et al. 2017

View full text Add to dashboard Cite

Lymphocele formation after kidney transplantation is a frequent complication which causes pain, secondary graft loss, rehospitalizations and reoperations. Therefore, prophylaxis of lymphocele formation is of utmost importance. To assess the effectiveness of peritoneal fenestration in renal transplantation to prevent lymphocele development. A systematic literature search was conducted combined with hand-searches on lymphocele prevention following renal transplantation using peritoneal fenestration. A qualitative and quantitative analysis of included trials was conducted. We identified three trials including 414 patients and 437 transplantations which studied peritoneal fenestration. Only one randomized controlled trial was identified. Critical appraisal uncovered a number of methodological flaws, predominantly in the nonrandomized studies. Most importantly endpoint definitions varied among trials, selection bias was high and interventions and follow-up were not standardized. Meta-analysis of the included trials showed a significant reduction of clinically symptomatic lymphoceles (OR: 0.23, 95% CI: 0.09-0.64, P = 0.005) and overall postoperative fluid collections (OR: 0.49, 95% CI: 0.28-0.88, P = 0.02) without a significant increase in other surgical complications. Although peritoneal fenestration is a promising technique to reduce lymphocele formation, only few studies have investigated this technique so far. Given the low methodological quality of included trials, more studies are necessary to evaluate the effectiveness and the risks and benefits of this technique.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prophylaxis of lymphocele formation after kidney transplantation via peritoneal fenestration: a systematic review

et al. 2017

View full text Add to dashboard Cite

show abstract

“…). Eighty‐seven articles met the inclusion criteria and were included in the report. Seventy‐six articles reported on lymphoceles only, four articles on lymphorrhoea, and seven articles on lymphocele and lymphorrhoea.…”

Section: Resultsmentioning

confidence: 99%

“…Varying definitions of lymphatic complications mean that results from different studies cannot be compared. In the past decade, international study groups have introduced classifications of different postoperative complications in hepatopancreatobiliary surgery, such as bile leakage and pancreatic fistula.…”

Section: Introductionmentioning

confidence: 99%

Consensus on definition and severity grading of lymphatic complications after kidney transplantation

Mehrabi

Kulu

Sabagh

et al. 2020

British Journal of Surgery

View full text Add to dashboard Cite

Background: The incidence of lymphatic complications after kidney transplantation varies considerably in the literature. This is partly because a universally accepted definition has not been established. This study aimed to propose an acceptable definition and severity grading system for lymphatic complications based on their management strategy. Methods: Relevant literature published in MEDLINE and Web of Science was searched systematically. A consensus for definition and a severity grading was then sought between 20 high-volume transplant centres.Results: Lymphorrhoea/lymphocele was defined in 32 of 87 included studies. Sixty-three articles explained how lymphatic complications were managed, but none graded their severity. The proposed definition of lymphorrhoea was leakage of more than 50 ml fluid (not urine, blood or pus) per day from the drain, or the drain site after removal of the drain, for more than 1 week after kidney transplantation. The proposed definition of lymphocele was a fluid collection of any size near to the transplanted kidney, after urinoma, haematoma and abscess have been excluded. Grade A lymphatic complications have a minor and/or non-invasive impact on the clinical management of the patient; grade B complications require non-surgical intervention; and grade C complications require invasive surgical intervention.Conclusion: A clear definition and severity grading for lymphatic complications after kidney transplantation was agreed. The proposed definitions should allow better comparisons between studies.

show abstract

“…The reported incidence of lymphocele ranges between 0.6% to 49%[40]. Franchin et al[35] have described successful management of a large deep-seated lymphocele infected with Staphylococcus haemolyticus , Escherichia coli and Enterococcus faecal , with the application of NPWT.…”

Section: Resultsmentioning

confidence: 99%

Systematic review of the negative pressure wound therapy in kidney transplant recipients

Shrestha¹

2016

WJT

View full text Add to dashboard Cite

AIMTo review negative pressure wound therapy (NPWT) as an important addition to the conventional methods of wound management.METHODSA systematic review, performed by searching the PubMed, EMBASE and Cochrane Library databases, showed 11 case reports comprising a total of 22 kidney transplantation (KT) patients (range, 1 to 9), who were treated with NPWT. Application of NPWT was associated with successful healing of wounds, leg ulcer, lymphocele and urine leak from ileal conduit.RESULTSNo complications related to NPWT were reported. However, there was paucity of robust data on the effectiveness of NPWT in KT recipients; therefore, prospective studies assessing its safety and efficacy of NPWT and randomised trials comparing the effectiveness of NPWT with alternative modalities of wound management in KT recipients is recommended.CONCLUSIONNegative pressure incision management system, NPWT with instillation and endoscopic vacuum-assisted closure system are in investigational stage.

show abstract

Laparoscopic treatment of lymphoceles after renal transplantation

Abstract: ARTICLE INFO ___________________________________________ _

Cited by 27 publications

References 16 publications

Prophylaxis of lymphocele formation after kidney transplantation via peritoneal fenestration: a systematic review

Prophylaxis of lymphocele formation after kidney transplantation via peritoneal fenestration: a systematic review

Consensus on definition and severity grading of lymphatic complications after kidney transplantation

Systematic review of the negative pressure wound therapy in kidney transplant recipients

Contact Info

Product

Resources

About

Laparoscopic treatment of lymphoceles after renal transplantation

Abstract: ARTICLE INFO _______________________________________________________________ _____________________

Cited by 27 publications

References 16 publications

Prophylaxis of lymphocele formation after kidney transplantation via peritoneal fenestration: a systematic review

Prophylaxis of lymphocele formation after kidney transplantation via peritoneal fenestration: a systematic review

Consensus on definition and severity grading of lymphatic complications after kidney transplantation

Systematic review of the negative pressure wound therapy in kidney transplant recipients

Contact Info

Product

Resources

About

Abstract: ARTICLE INFO ___________________________________________ _