Title: Management of Lymphocele Formation Following Kidney Transplantation: A Single Centre Experience
Authors: Shanky Singh, Vaibhav Vikas, Priyabrat Das, Jatin Soni
DOI: https://dx.doi.org/10.18535/jmscr/v5i6.127
Abstract
Background: A lymphocele is defined as a collection of lymph that accumulates in the postoperative field in a nonepithelialized cavity. Incidence ranges from 0.6% to 18% depending on various studies.1 Management of lymphocele varies from simple aspiration or aspiration with sclerotherapy to more invasive technique, such as internal/external drainage.2-9 We present our experience in the management of 13 patients who developed pelvic lymphocele after renal transplant.
Materials and Methods: Between January 2014 and December 2016, a total of 13 patients after renal transplant were treated in our institution for post-transplant lymphocele formation that occurred during follow-up at the transplant outpatient department. Retrospectively analysis of the clinical data of these patients was done.
Results: All thirteen patients who had a clinically significant lymphocele post renal transplant underwent first ultrasound guided aspitation of lymphocele. Five out of 13 patients had successful treament with percutaneous aspiration alone. Two patients became assymptomatic after percutaneous drain placement and sclerosant injection. Six patients who failed percutaneous drain insertion therapy after aspiration underwent marsupilization. Laparoscopic marsupilization was done in four patients and open marupilization was done in one patient.One patient had open procedure after failed laparoscopy procedure.
Conclusion: Most patients with lymphocele post renal transplant may be asymptomatic. Management of lymphocele depend upon symptoms and renal function and should be in a step ladder fashion . It usually starts from percutaneous drainage to laparoscopic marsupilization to open surgical approach.
Keywords: Lymphocele; Percutaneous drainage; Marsupialization; Post renal transplant.
