Abstract
ABSTRACT
In pediatric and adult, patients pelvic lymphocele represents a potential complication of renal transplantation. The appropriate treatment of symptomatic cases is still debated. External drainage risks possible recurrence, while laparotomy and intraperitoneal marsupialization seems to be too extensive a procedure. Recently, the laparoscopic approach has been proposed as a reasonable alternative. The authors report their experience with this technique during January 1988 through December 1997, when 147 renal transplantation procedures were performed, resulting in 11 cases of pelvic lymphocele. Three cases resolved spontaneously, and two were successfully treated by percutaneous drainage. The last six patients were laparoscopically treated. The laparoscopy was performed with an open technique using three trocars; a peritoneal window was created and secured open with titanium clips. The operative times varied between 30 and 45 minutes, and no conversion was required. Recurrence occurred in one case, which required laparotomy. At follow-up, ranging from 6 months to 3 years, all five patients treated laparoscopically were asymptomatic, and sonographic results were normal. Laparoscopic marsupialization of symptomatic lymphocele, unresolved by external drainage, is an easy and effective alternative to the open surgical approach.
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