Minimal invasive methods for treatment of lymphocele after kidney transplantation

Background: One of the most often occurring complications after kidney
transplantation is a lymphocele. The aim of our work was an analysis of incidence of lymphocele and the effectiveness of minimal invasive methods of treatment.
Material/Methods: The examined group was consisted of one hundred and
eighteen patients (90 male and 68 female) with the end stage renal disease (ESRD).
Results: 21 patients (13%) developed symptoms of lymphocele after transplantation within an average time of 34 weeks. The clinical symptoms included: decrease of 24-hour urine output, increase in a creatinine level abdominal discomfort, lymphorrhoea with a surgical wound dehiscence, urgency and vesical tenesmus, febrile state and deep vein thrombosis. The lymphocele was noticed in patients with excessive bleeding during transplantation, in patients with diabetic nephropathy, congenital malformations of the urinary tract, inflammatory diseases, including glomerule and extraglomerule nephropathy, after RTG-therapy and after removal of the renal graft. The efficient methods of treatment were: percutaneous aspiration with recurrence of 100%, percutaneous drainage guided by ultrasound - 55%, laparoscopic intraabdominal marsupialisation (85% good results) and a classic surgical intervention with favourable results.
Conclusions: A percutaneous drainage guided ultrasound should be recommended as the first line of treatment. As a minimal invasive surgery this kind of treatment does not interfere with subsequent internal drainage trough open or laparoscopic surgery. Laparoscopy is a feasible and safe technique
and should be used routinely after unsuccessful percutaneous drainage.

Keywords: Kidney Transplantation