Ventral hernia following lymphocele fenestration in a patient after renal transplantation – a case report and treatment strategy
Introduction: Lymphocele is a common finding after renal transplantation. The frequency of this complication is up to38%; of these, only 10% need surgical treatment. Unfortunately, hernia may be observed as a consequence of a lymphoceleor its treatment.Aim: To show the need for a complex approach to...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Medycyna Praktyczna
2010-12-01
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| Series: | Videosurgery and Other Miniinvasive Techniques |
| Subjects: | |
| Online Access: | http://www.termedia.pl/Ventral-hernia-following-lymphocele-fenestration-in-a-patient-after-renal-transplantation-a-case-report-and-treatment-strategy,42,15802,1,0.html |
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| Summary: | Introduction: Lymphocele is a common finding after renal transplantation. The frequency of this complication is up to38%; of these, only 10% need surgical treatment. Unfortunately, hernia may be observed as a consequence of a lymphoceleor its treatment.Aim: To show the need for a complex approach to patients who have undergone kidney transplantation and in whomlymphocele has occurred. The secondary goal is to draw attention to the lack of randomized clinical trials which couldgive an answer to what type of approach the surgeon should use.Case report: A 59-year-old woman underwent renal transplantation in June 2006. After one month a large lymphoceleoccurred surrounding the transplanted kidney, impressing the vein of the graft. In ultrasound examination, postoperativehernia was found. In August 2006 fenestration of the lymphocele was performed by the open approach withsimultaneous onlay technique for repair of the hernia using PP mesh. In September 2006 the patient was admitted tothe hospital with symptoms of bowel obstruction. Laparoscopy revealed colic intussusceptions into the post-fenestrationorifice, which were liberated during the procedure. Hernia repair using laparoscopic intraperitoneal onlay mesh(IPOM) technique with ePTFE mesh was performed. Mesh was placed with a 5 cm overlap, using Protack tacks in the“double-crown” technique.Conclusions: The presented case highlights the complexity of problems of ventral hernias occurring in patients whohave undergone lymphocele treatment after renal transplantation. The surgical management should differ in differentgroups of patients (with hernia, with lymphocele, with both problems). Whether the open or the laparoscopicapproach was used for that operation should be taken into consideration. |
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| ISSN: | 1895-4588 |