Search results

Search:
in the keywords: lymphocele

Sort By:

Limit search:

Prophylactic intra-abdominal drainage following kidney transplantation: a systematic review and meta-analysis

100%

Zawistowski M., Nowaczyk J., Domagała P.

Polish Journal of Surgery

2021

vol. 93

issue 4

1-10

Introduction: An ongoing debate concerns the need for routine placement of prophylactic intra-abdominal drains following kidney transplantation. Aim: We conducted a systematic review and meta-analysis to determine whether such an approach brings any advantages in the prevention of perirenal transplant fluid collection, surgical site infection, lymphocele, hematoma, urinoma, wound dehiscence, graft loss, and need for reoperation. Methods: We conducted a random-effects meta-analysis of non-randomized studies of intervention comparing drained and drain-free adult renal graft recipients regarding perirenal transplant fluid collection and other wound complications. ROBINS-I tool and funnel plot asymmetry analysis were used to assess the risk of bias. Results: Five studies at moderate to critical risk of bias were included. A total of 2094 renal graft recipients were evaluated. Our analysis revealed no significant differences between drained and drain-free patients regarding perirenal transplant fluid collection (pooled odds ratio [OR], 0.77; 95% confidence interval [CI], 0.28–2.17; I 2 = 72%), surgical site infection (OR, 1.64; 95% CI, 0.11–24.88; I 2 = 80%), lymphocele (OR, 0.61; 95% CI, 0.02–15.27; I 2 = 0%), hematoma (OR, 0.71; 95% CI, 0.12–3.99; I 2 = 71%), and wound dehiscence (OR, 0.75; 95% CI, 0.21–2.70; I 2 = 0%). There was insufficient data concerning urinoma, graft loss, and need for reoperation. Conclusions: The available evidence is weak. Our findings show that the use of intra-abdominal drains after kidney transplantation seems to have neither beneficial nor harmful effects on perirenal transplant fluid collection and other wound complications. The present study does not support the routine placement of surgical drains after kidney transplantation. In this systematic review and meta-analysis we summarize the most up-to-date evidence for and against the routine use of intra-abdominal drain following renal transplantation.

Chylous complications of various severity and manifestations within diverse compartments in reconstructive vascular surgery #) #) The manuscript is dedicated to Prof. Dr. Z. Halloul

86%

Barth U., Wasseroth K., Rahms V., Albrecht R., Meyer F.

Polish Journal of Surgery

2018

vol. 90(3)

43-48

Introduction: Chylous complications, which also occur in the profile of vascularsurgical interventions with considerable frequency, are challenging with regard to their adequate management. Aim & method: Short compact overview on epidemiological, classifying, symptomatic, diagnostics and therapeutic aspects of chylous complications in vascular surgery, based on •own clinical experiences,   •current selection of relevant scientific references, and   •representative case reports from clinical practice. Results (complex patient- & clinical finding-associated aspects): •Basic treatment of lymphedema / postreconstructive edema comprises a complex physical therapy to improve edematous swelling, which needs to be usually performed over years. •In case of lymphocele, a wait-and-see strategy can be initially pursued to observe spontaneous clinical course. If the lymphocele and its clinical complaints persist, puncture, placement of drainage or temporary instillation of doxycyclin or ethanol can be attempted. •In case of lymphatic fistula, vacuum-assisted closure dressing, radiation and selective ligation of lymphatic vessels after previous application of methylene blue dye can be used. •Chylascites and chylothorax should be primarily treated – as has been widely established in the meantime – with a consequently conservative approach initially comprising paracentesis / thoracocentesis, protein-enriched and low-fat diet containing middle-chain triglycerides (MCT) or total parenteral nutrition combined with the application of a somatostatin analogue (surgical approach as ultima ratio only aiming at ligation of the lesioned lymphatic vessel – if necessary, including preoperative consumption of cream). Summary: Chylous complications can be primarily treated with conservative measures, which should be exploited using a step-wise approach prior to surgical intervention as ultima ratio. Conclusion: The experienced vascular surgeon should be acquainted with a sufficient, finding-adapted management of chylous complications. This requires a well-experienced clinician and surgeon with great expertise regarding the interdisciplinary setting comprising of interventional radiology, vascular (abdominal) surgery and partially surgical intensive care.

Refine search results

2 Polish Journal of Surgery

1 2021

1 2018

1 Albrecht R.

1 Barth U.

1 Domagała P.

1 Meyer F.

1 Nowaczyk J.

1 Rahms V.

1 Wasseroth K.

1 Zawistowski M.

Search results

Prophylactic intra-abdominal drainage following kidney transplantation: a systematic review and meta-analysis

Chylous complications of various severity and manifestations within diverse compartments in reconstructive vascular surgery #) #) The manuscript is dedicated to Prof. Dr. Z. Halloul