ORIGINAL ARTICLES   

Italian Journal of Vascular and Endovascular Surgery 2004 March;11(1):53-6

Copyright © 2005 EDIZIONI MINERVA MEDICA

language: English

Laparoscopic treatment of retroperitoneal lymphocele after aortic surgery. A case report

Fracchia E. ¹, Mortola P. ¹, Baldino G. ¹, Bagarolo C. ², Cappato S. ², Gori A. ¹

¹ Vascular Surgery Complex Structure, E.O. Galliera Hospitals, Genoa, Italy 2 Hepatobiliary and Pancreatic Surgery Simple Structure, E.O. Galliera Hospitals, Genoa, Italy

Retroperitoneal lym­pho­cele is a ­rare com­pli­ca­tion of aor­tic recon­struc­tive sur­gery ­using a syn­thet­ic ­graft. Thirteen cas­es ­have ­been report­ed in lit­er­a­ture, of ­which 2 ­were treat­ed ­using a lapar­os­cop­ic tech­nique. The ­authors ­report a ­case of ret­ro­per­i­to­neal lym­pho­cele treat­ed ­with a trans­per­it­o­neal lapar­os­cop­ic tech­nique. The prob­lems regard­ing diag­no­sis and the treat­ment of the ­lesion are exam­ined: a cor­rect diag­no­sis, drain­age of the col­lec­tion, fen­es­tra­tion of the lym­pho­cele and liga­tion of the leak­ing lym­phat­ic ves­sels are the under­ly­ing fac­tors for ther­a­peu­tic suc­cess. This meth­od ­ensures excel­lent ­long-­term ­results ­because lapar­os­cop­ic drain­age is ­easy to per­form, ­safe and effec­tive, ­with low mor­bid­ity and dis­charge of the ­patient with­in 24-48 ­hours ­after sur­gery. Intraoperative lapar­os­cop­ic ultra­so­nog­ra­phy is per­formed to loc­al­ise the lym­pho­cele. In addi­tion, the use of lapar­os­cop­ic ultra­so­nog­ra­phy ­allows the lym­phat­ic col­lec­tion, the ure­ter and ­graft to be iden­ti­fied, ­which ­helps to tar­get sur­gery.