Critical appraisal of consecutive 36 cases of post renal transplant lymphocele: a proposed algorithm

Singh, Abhishek; Jai, Shrikant; Ganpule, Arvind; M, Vijaykumar; Sabnis, Ravindra; Desai, Mahesh

doi:10.1007/s00345-016-1997-x

Cited by 11 publications

(8 citation statements)

References 15 publications

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“…). 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%

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

Mehrabi

Kulu

Sabagh

et al. 2020

British Journal of Surgery

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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.

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Section: Resultsmentioning

confidence: 99%

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

Mehrabi

Kulu

Sabagh

et al. 2020

British Journal of Surgery

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“…Another more radical option is marsupialization. This surgical procedure offers low morbidity, fast recovery, and a low recurrence rate (<15%) 13,14 …”

Section: Discussionmentioning

confidence: 99%

“…This surgical procedure offers low morbidity, fast recovery, and a low recurrence rate (<15%). 13,14 Lymphatic embolization has been an emerging technique for several years to treat PL. Baek et al reported a 95% efficacy in a series of 21 patients after gynecological surgery.…”

Section: Discussionmentioning

confidence: 99%

Lymphatic embolization for the management of symptomatic pelvic lymphocele after radical prostatectomy with lymph node dissection: Report of two cases

et al. 2020

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“…6 Similarly, Choudhrie et al, and Singh et al, from India, had successfully cured 80% (4 out of 5) and 85.7 % (18 out of 21) lymphocele patients by laparoscopic marsupialization in their respective series. 7,8 IKDRC, Ahmedabad, is the leading renal transplant center in West India, where laparoscopic urological surgeries are performed on daily basis.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic deroofing of post-renal transplant lymphoceles – A single-center observational study

et al. 2022

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Background: Lymphocele formation is the most common identifiable surgical complication of renal transplant recipients, which often requires surgical deroofing. In this retrospective study, we are determining the efficacy of laparoscopic deroofing surgery in the management of post-renal transplant lymphocele. Aims and Objectives: This study aims to determine the efficacy of laparoscopic deroofing surgery in the management of post-renal transplant lymphocele. Materials and Methods: All patients who underwent surgical deroofing for post-renal transplant lymphocele at the Institute of Kidney DISEASE and Research Center, Ahmedabad, India, between January 2016 and October 2019 were included in the study and retrospectively reviewed. Information about symptomatology, clinical features, radiological findings, preoperative drainage, ultrasound-guided percutaneous nephrostomy (PCN) diversion, intraoperative, post-operative findings, and complications were retrieved and analyzed. Results: Among the 1138 open renal transplant recipients, 28 patients developed symptomatic lymphocele (incidence 2.5%). The mean interval to develop these lymphoceles was 8 weeks (3 weeks–4 months). All 28 patients underwent laparoscopic lymphatic deroofing surgery. There were no conversions to open surgery. Overrunning of cut edges was performed in six and omentopexy in two patients, rest of the 20 patients only deroofing of lymphocele was performed. Graft PCN was placed before surgery in four patients and in two patients, percutaneous drain was placed into the lymphocele. The mean operative time was 80 min. The mean hospital stay was 3.5 days. In one case, there was an injury to the ureter intraoperatively which was repaired over a DJ stent laparoscopically. There was one case with recurrence who had a prior history of continuous ambulatory peritoneal dialysis. He was explored and perivascular lymphatics were tied and omental packing was performed. Conclusion: Laparoscopic deroofing of symptomatic lymphoceles following renal transplantation appears to be safe and effective, because it has minimal post-operative morbidity, rapid convalescence, and low recurrence rate. Laparoscopy should be considered the first-line treatment for symptomatic lymphoceles.

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Critical appraisal of consecutive 36 cases of post renal transplant lymphocele: a proposed algorithm

Cited by 11 publications

References 15 publications

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

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

Lymphatic embolization for the management of symptomatic pelvic lymphocele after radical prostatectomy with lymph node dissection: Report of two cases

Laparoscopic deroofing of post-renal transplant lymphoceles – A single-center observational study

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