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首页> 外文期刊>Surgical Endoscopy >Laparoscopic treatment of post renal transplant lymphoceles.
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Laparoscopic treatment of post renal transplant lymphoceles.

机译：腹腔镜治疗肾移植后淋巴结肿大。

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Background: Traditionally, a post transplant lymphocele (PTL) is drained by widely opening the wall connecting the lymphocele cavity to the intraperitoneal space via laparotomy. We hypothesize that laparoscopic techniques can be effectively used for the treatment of PTL. Methods: Patients requiring intervention for PTL between 1993 and 2002 were identified via a retrospective review. Results of drainage via laparotomy and laparoscopy were compared. Results: During the study period 685 renal transplants (391 cadaveric, 294 living) were performed. The incidence of lymphocele was 5% [34/685 (36 cases)]. The indications for surgical drainage were local symptoms (69%), graft dysfunction (14%), or both (17%). The mean time to surgical therapy was 4.9 months. Laparoscopic drainage was performed in 25 patients (74%) and open drainage in 9 patients (26%). Open procedures were performed in cases for: previous abdominal surgery (5), undesirable lymphocele characteristics or location (2), or with concomitant open procedures (3). There were no conversions or operative complications in either group. There was no difference in operative time for the laparoscopic group vs the open group (108 +/- 6 vs 123 +/- 18 min, p = 0.8). Hospital stay was significantly shorter for the laparoscopic group (1.7 +/- 0.8 vs 3.8 +/- 1.0, p = 0.0007), with 88% of laparoscopic patients being either overnight admissions or same day surgery. Two patients (5%) developed symptomatic recurrences requiring reoperation [1 laparoscopic (4%), 1 open (10%)]. Conclusions: Laparoscopic fenestration of a peritransplant lymphocele is a safe and effective treatment. The large majority of patients treated with laparoscopic fenestration were discharged within one day of surgery. Unless contraindications exist, laparoscopy should be considered first-line therapy for the surgical treatment of posttransplant lymphocele.
机译：背景：传统上，通过剖腹术广泛打开连接淋巴球腔与腹膜腔的壁，从而排干移植后的淋巴球（PTL）。我们假设腹腔镜技术可以有效地用于治疗PTL。方法：通过回顾性研究确定1993年至2002年期间需要干预PTL的患者。比较了通过剖腹术和腹腔镜引流的结果。结果：在研究期间，进行了685例肾移植（391例尸体，294例活体）。淋巴囊肿的发生率为5％[34/685（36例）]。手术引流的指征是局部症状（69％），移植物功能障碍（14％）或两者（17％）。手术治疗的平均时间为4.9个月。腹腔镜引流术25例（74％），开放引流术9例（26％）。在以下情况下进行开放手术：先前的腹部手术（5），不良的淋巴膨出特征或位置（2）或伴有开放手术（3）。两组均无转换或手术并发症。腹腔镜组与开放组的手术时间无差异（108 +/- 6 vs 123 +/- 18 min，p = 0.8）。腹腔镜组的住院时间明显缩短（1.7 +/- 0.8对3.8 +/- 1.0，p = 0.0007），其中88％的腹腔镜患者是通宵入院或当天手术。 2例（5％）出现症状复发，需要再次手术[1例腹腔镜（4％），1例开放（10％）]。结论：腹腔镜开窗术是一种安全有效的治疗方法。接受腹腔镜开窗术治疗的大多数患者在手术的一天之内出院。除非有禁忌症，否则应将腹腔镜手术视为移植后淋巴膨出手术治疗的一线治疗方法。

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