Instillation of povidone iodine to treat and prevent lymphocele after renal transplantation

Chandrasekaran, D.; Meyyappan, RM; T, Rajaraman

doi:10.1046/j.1464-410x.2003.04028.x

Cited by 26 publications

(12 citation statements)

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“…Another option is percutaneous insertion of a drainage catheter, with or without sclerotherapy; however, this option is associated with some risk of recurrence or infection. A variant approach is to initially drain the lymphoceles percutaneously after inserting a drainage catheter; sclerotherapy is then attempted via this catheter (15). If the lymphoceles continue to drain, if they recur, or if they were not amenable to percutaneous drainage, then a laparoscopic or open peritoneal window should be created.…”

Section: Surgical Complicationsmentioning

confidence: 99%

Surgical Complications After Kidney Transplantation

Humar

Matas

2005

Seminars in Dialysis

176

117

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Kidney transplants have become common surgical procedures, with thousands performed yearly around the world. The surgical techniques for the transplant are well established and the procedure is associated with high success rates. The complication rate associated with the procedure is low, especially when compared to other abdominal organ transplants such as liver and pancreas transplants. Nonetheless, the detection, accurate diagnosis, and timely management of surgical complications occurring after kidney transplant are important tasks of the team managing these patients. A delay in the diagnosis or management of these complications can result in significant morbidity to the recipient, with risk of graft loss and mortality. Most surgical complications involve either the wound or one of the three anastomoses (renal artery, renal vein, or ureter). Examples include wound infection, renal artery or vein thrombosis, and urine leak. Most of these complications will require surgical or radiologic intervention for appropriate management.

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Section: Surgical Complicationsmentioning

confidence: 99%

Surgical Complications After Kidney Transplantation

Humar

Matas

2005

Seminars in Dialysis

176

117

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“…In addition, the immunosuppressive regime seems to influence the rate of lymphoceles and appropriate adaptation can reduce the risk . Some authors have used polymeric sealants/haemostatic biomaterial or povidone‐iodine to reduce lymphocele formation; however, these methods either lack high‐quality evidence, are not cost‐effective or did not significantly decrease post‐KTx lymphoceles. The use of drains to prevent lymphocele formation is controversial .…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2017

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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.

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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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Instillation of povidone iodine to treat and prevent lymphocele after renal transplantation

Cited by 26 publications

References 0 publications

Surgical Complications After Kidney Transplantation

Surgical Complications After Kidney Transplantation

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

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