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2016 ; 91
(3
): 133-8
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Evaluation of postoperative lymphocele according to amounts and symptoms by using
3-dimensional CT volumetry in kidney transplant recipients
#MMPMID27617254
Jun H
; Hwang SH
; Lim S
; Kim MG
; Jung CW
Ann Surg Treat Res
2016[Sep]; 91
(3
): 133-8
PMID27617254
show ga
PURPOSE: To analyze the risk factors for postoperative lymphocele, for predicting
and preventing complications. METHODS: We evaluated 92 kidney transplant
recipients with multidetector CT (MDCT) at 1-month posttransplantation. From
admission and 1-month postoperative records, data including diabetes, dialysis
type, immunosuppressant use, steroid pulse therapy, and transplantation side were
collected. Lymphocele volume was measured with 3-dimensional reconstructed,
nonenhanced MDCT at one month postoperatively. The correlations between risk
factors and lymphocele volume and between risk factors and symptomatic lymphocele
(SyL) were analyzed. The cutoff was calculated by using the receiver operating
characteristic (ROC) curve for SyL volume. RESULTS: Among 92 recipients, the mean
volume was 44.53 ± 176.43 cm(3) and 12 had SyL. Univariable analysis between risk
factors and lymphocele volume indicated that donor age, retransplantation, and
inferiorly located lymphocele were statistically significant. The ROC curve for
SyL showed that 33.20 cm(3) was the cutoff, with 83.3% sensitivity and 93.7%
specificity. On univariable analysis between risk factors and SyL, steroid pulse,
inferiorly located lymphocele, and >33.20 cm(3) were statistically significant.
Multivariable analysis indicated that steroid pulse, >33.20 cm(3), and serum
creatinine level at one month were significant factors. CONCLUSION: Risk factors
including donor age, retransplantation, steroid pulse therapy, and inferiorly
located lymphocele are important predictors of large lymphoceles or SyL. In
high-risk recipients, careful monitoring of renal function and early image
surveillance such as CT or ultrasound are recommended. If the asymptomatic
lymphocele is >33.20 cm(3) or located inferiorly, early interventions can be
considered while carefully observing the changes in symptoms.