Does opening the peritoneum at the time of renal transplanation prevent lymphocele formation? Transplant Proc 2006 Dec;38(10):3524-6
Date
12/19/2006Pubmed ID
17175321DOI
10.1016/j.transproceed.2006.10.182Scopus ID
2-s2.0-33845443705 (requires institutional sign-in at Scopus site) 14 CitationsAbstract
BACKGROUND: The occurrence of lymphocele formation following renal transplantation is variable, and the optimal approach to treatment remains undefined. Opening the peritoneum at the time of transplantation is one method of decreasing the incidence of lymphocele formation. The purpose of this study was to determine whether creating a peritoneal window at the time of transplantation decreases the incidence of lymphocele formation.
METHODS: We performed a retrospective review of renal transplants conducted at our institution between 2002 and 2004. Records were reviewed to obtain details regarding opening of the peritoneum at the time of transplant and occurrence of lymphocele. Every patient underwent routine ultrasound imaging in the peri-operative period. Graft dysfunction secondary to the lymphocele was the primary indication for intervention. Data were analyzed by chi-square.
RESULTS: During the initial transplant the peritoneum was opened in 35% of patients. The overall incidence of fluid collections, identified by ultrasound, was 24%. Opening the peritoneum did not decrease the incidence of lymphocele. However, more patients with a closed peritoneum required an intervention for a symptomatic lymphocele. In the 11 patients with an open peritoneum and a fluid collection, only one required an intervention. In patients whose peritoneum was left intact, 24% of fluid collections required intervention. Graft survival was equivalent.
CONCLUSION: Creating a peritoneal window at the time of transplantation did not decrease the overall incidence of postoperative fluid collections. However, forming a peritoneal window at the time of transplantation did decrease the incidence of symptomatic lymphocele.
Author List
Layman RE, McNally M, Kilian C, Linn J, Roza A, Johnson CP, Adams MB, Shames BDAuthor
Christopher P. Johnson MD Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
HumansIncidence
Kidney Transplantation
Lymphocele
Peritoneum
Postoperative Complications
Retrospective Studies
