Laparoscopic Lymphocelectomy: A Multi-Institutional Analysis

Abstract

Laparoscopic lymphocelectomy is safe, minimally invasive and effective. It is an excellent alternative to the conventional open surgical approach.

Laparoscopic treatment of lymphoceles after renal transplantation

“…In our series of 991 patients studied over 12 years, the incidence of lymphocele was 2.52%, which is comparable to the rate of 1% to 12% of patients observed in other reviews (8). The occurrence of lymphoceles after surgery for kidney transplantation does not seem to be the result of any single factor (9).…”

Management of Lymphocele Formation Following Kidney Transplantation: A Single Centre Experience

“…The recommended surgical intervention for lymphoceles is laparoscopic marsupialisation, as it is less invasive, and has shorter operative time and hospital stay, as well as better cosmesis. The recurrence rates following it (range 6%-12%) 2,7 and open drainage (range 6.7%-13%) 3,7 are comparable. In our study, conservative and less invasive treatment, such as percutaneous drainage, was successful in 53.84% of patients.…”

“…High incidence (50%-100%) of recurrence is associated with percutaneous aspiration of lymphocele. 2 Laparoscopic marsupialisation is considered by some surgeons as the first line treatment of lymphoceles, 2,3 while others have suggested initial percutaneous aspiration under ultrasonographic guidance, followed by sclerotherapy to prevent reaccumulation of fluid. [4][5][6] Recurrence risk of lymphocele has been shown to reduce (range 13%-33%) [7][8][9] with percutaneous aspiration as has additional sclerotherapy (range 6%-25%).…”

“…[4][5][6] Recurrence risk of lymphocele has been shown to reduce (range 13%-33%) [7][8][9] with percutaneous aspiration as has additional sclerotherapy (range 6%-25%). 2,4,7 Doxycycline and ethanol are common sclerosing agents used in sclerotherapy. 5 Other sclerosing agents which can be used are povidone-iodine, talc and bleomycin.…”

“…The lymph can origin from the lymphatic vessels either in the sinus of the transplanted kidney or surrounding the iliac vessels of the recipient. 1,2 The reported incidence of lymphoceles ranges widely, from 1%-2% to as high as 20%. 1 asymptomatic, but large ones can cause compression of the pelvicalyceal system, resulting in hydronephrosis and worsening renal function.…”