Evaluation of postoperative lymphocele according to amounts and symptoms by using 3-dimensional CT volumetry in kidney transplant recipients

Heungman Jun; Sung Ho Hwang; Sungyoon Lim; Myung Gyu Kim; Cheol Woong Jung

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자료유형: 학술저널

저자정보: Heungman Jun (Korea University Anam Hospital) Sung Ho Hwang (Korea University Anam Hospital) Sungyoon Lim (Korea University Anam Hospital) Myung Gyu Kim (Korea University Anam Hospital) Cheol Woong Jung (Korea University Anam Hospital)

저널정보: 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.91 No.3

발행연도: 2016.9

수록면: 133 - 138 (6page)

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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 cm3 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 cm3 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 cm3 were statistically significant. Multivariable analysis indicated that steroid pulse, >33.20 cm3, 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 cm3 or located inferiorly, early interventions can be considered while carefully observing the changes in symptoms.

#Kidney transplantation #Lymphocele #Cone-beam computed tomography #Three-dimensional imaging

참고문헌 (16)

참고문헌 신청

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[학술지(정기간행물)] - Ulrich F. / 2010 / Symptoma tic lymphoceles after kidney transplan tation-multivariate analysis of risk fac tors and outcome after laparoscopic fe ne stra tion / Clin Transplant 24 : 27380 ~

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[학술지(정기간행물)] - Chajes V. / 2015 / Plasma elai dic acid level as biomarker of industrial trans fatty acids and risk of weight change: report from the EPIC study / PLoS One 10 : e0118206 ~

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