The Experts below are selected from a list of 861 Experts worldwide ranked by ideXlab platform
Wen Ming Chen - One of the best experts on this subject based on the ideXlab platform.
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management of recurrent lymphocele after renal transplantation using the Tenckhoff Catheter
Urology, 2009Co-Authors: Wen Ming ChenAbstract:We use the double-cuff straight Tenckhoff Catheter for internalized drainage of the lymphocele into the peritoneal cavity by a subcutaneous tunneling technique. This technique has been performed in a 53-year-old male patient with recurrent symptomatic lymphocele after renal transplantation. There was no evidence of lymphocele recurrence at 6-month follow-up. We believe it is a safe technique to treat the recurrent lymphocele after renal transplantation.
Larry C Munch - One of the best experts on this subject based on the ideXlab platform.
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intraperitoneal drainage of recurrent lymphoceles using an internalized Tenckhoff Catheter
The Journal of Urology, 1994Co-Authors: Bruce A Lucas, Inderbir S Gill, Larry C MunchAbstract:Occasionally, lymphoceles recur after renal transplantation in relatively inaccessible pelvic locations, usually in the setting of a transversely oriented allograft that separates the lymphocele from the peritoneal cavity. Such lymphoceles do not share a common wall with the peritoneal cavity and, therefore, are not manageable by conventional open surgical or laparoscopic drainage techniques. We used an internalized Tenckhoff Catheter to drain recurrent lymphoceles into the peritoneal cavity in 3 patients who had undergone prior renal transplantation. No evidence of lymphocele recurrence or Catheter-induced septic complications have been noted in our immunocompromised patients up to a mean followup of 5.3 years. Our experience with this alternative management option for the recurrent, inaccessible lymphocele is presented along with a single case report of intractable, recurrent perinephric fluid collection in the nontransplant setting treated by the same technique.
Hideo Yoneshima - One of the best experts on this subject based on the ideXlab platform.
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Laparoscopic Mesenterioadhesiotomy and Tenckhoff Catheter Placement in Patients with Predisposing Abdominal Surgery
Artificial Organs, 1995Co-Authors: Satoshi Kurihara, Kazumi Nakajima, Masashi Takeuchi, Takashi Akiba, Haruhisa Inoue, Hideo YoneshimaAbstract:Peritoneoscopic surgery has been performed widely for a variety of abdominal surgical diseases. We describe here a safe and reliable technique of laparoscopic-assisted mesenterioadhesiotomy and peritoneal Tenckhoff Catheter placement in patients who have previously undergone abdominal surgery. Five patients suffering from end-stage renal failure previously underwent single and/or polyabdominal surgery. The surgical procedures included hysterectomy, ovarian resection, appendectomy, and transabdominal right nephrectomy. Under general endotrachial anesthesia, a laparoscope was placed down through a direct cut made using a trocar. After CO(2) gas insufflation, another one or two trocars were put in place for surgical procedures. To avoid intestinal injury, mesenterioadhesiotomy was performed carefully using a high-frequency hook electrode, forceps, and scissors forceps, and the Tenckhoff Catheter was subsequently inserted with forceps directly into Douglas' fossa. Peritoneal equilibration tests performed 30-70 days after the initiation of continuous ambulatory peritoneal dialysis (CAPD) treatment revealed moderate to good peritoneal effectiveness. This procedure permits the surgeon to perform safe and exact Catheter placement into Douglas' fossa even when there is a possibility that peritoneal and mesenterial adhesion are present. We believe that this technique of Catheter placement may extend the indication for CAPD treatment in patients with predisposing lower abdominal surgery.
Vittorio Bresadola - One of the best experts on this subject based on the ideXlab platform.
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treatment of recurrent symptomatic lymphocele after kidney transplantation with intraperitoneal Tenckhoff Catheter
Urology, 2007Co-Authors: Gian Luigi Adani, Umberto Baccarani, A Risaliti, Daniele Gasparini, Massimo Sponza, D Montanaro, P Tulissi, D De Anna, Vittorio BresadolaAbstract:Objectives The incidence of lymphocele after kidney transplantation ranges from 0.6% to 16%. The management of lymphocele is still controversial. Percutaneous needle aspiration and external drainage, with or without the injection of sclerosing solutions, are associated with high recurrence and complication rates. Open or laparoscopic intraperitoneal marsupialization requires hospital admission, general anesthesia, and, sometimes, extensive surgical dissection. Methods We report our experience treating recurrent symptomatic lymphocele with intraperitoneal drainage using a Tenckhoff Catheter on an outpatient basis in 7 consecutive patients. In all cases, the lymphocele was diagnosed by abdominal ultrasonography 26 to 90 days after kidney transplantation. The mean diameter of the lymphocele was 14 ± 6 cm. Percutaneous drainage was the initial approach, which was also used to differentiate between urinoma and lymphocele and to rule out infection. The lymphocele recurred within 1 month in all cases. The recurrent lymphoceles were treated on an outpatient basis using intraperitoneal drainage with a Tenckhoff Catheter inserted into the lymphocele under ultrasound guidance. After administration of local anesthesia, two 1-cm vertical incisions were performed: one to access the lymphocele and the other to access the peritoneal cavity. A Tenckhoff Catheter was inserted in the lymphocele and tunneled into the peritoneal cavity. Results All procedures were completed on an outpatient basis without any complications. The Catheter was removed 6 months later with no evidence of recurrent lymphocele at ultrasound follow-up in all cases. Conclusions This outpatient surgical approach using ultrasound-guided intraperitoneal drainage with a Tenckhoff Catheter appears to be a simple, effective, and safe method for treating unilobular recurrent symptomatic lymphocele after renal transplantation.
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intraperitoneal Tenckhoff Catheter for the treatment of recurrent lymphoceles after kidney transplantation our early experience
Congress of the Italian Society of Transplantation, 2007Co-Authors: Gian Luigi Adani, A Risaliti, Daniele Gasparini, Massimo Sponza, D Montanaro, P Tulissi, Vittorio Bresadola, Enrico Benzoni, D Lorenzin, Umberto BaccaraniAbstract:Lymphoceles may occur as frequently as 16% of the time after kidney transplantation, becoming clinically evident between 18 and 180 days after surgery. The management of lymphoceles is unclear. Percutaneous needle aspiration and external drainage are associated with high recurrence and complications. Surgical intraperitoneal marsupialization of lymphocele is considered the treatment of choice, but requires hospital admission, general anesthesia, and sometimes extensive surgical dissection. We discuss our experience in the treatment of recurrent symptomatic lymphocele intraperitoneally drained using a Tenckhoff Catheter in 7 consecutive patients. Clinical manifestations became evident between 26 and 90 days after transplantation. The diagnosis was obtained with abdominal ultrasound in all cases; mean lymphocele diameter was 14 ± 6 cm. After percutaneous drainage, performed to differentiate urinoma/lymphocele and to rule out infections, the lymphocele recurred within 1 month. Thereafter, we decided to treat recurrent lymphatic collection using a Tenckhoff Catheter. The lymphocele was located during the operative procedure using a sterile 3.5-MHz ultrasound probe. With the patient under local anesthesia, we performed 2 vertical 1-cm incisions to the lymphocele and peritoneum, respectively. The Tenckoff Catheter was first positioned into the lymphocele and the tunneled inside the peritoneal cavity. One cuff of the Tenckhoff was fixed to the fascia to avoid possible delocalization. The patients were discharged the same day. The Catheter was removed 6 months later with no evidence of lymphocele recurrence.
Tun-jun Tsai - One of the best experts on this subject based on the ideXlab platform.
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Revision of dysfunctional Tenckhoff Catheters by laparoscopic technique in continuous ambulatory peritoneal dialysis patients.
Journal of the Formosan Medical Association, 1993Co-Authors: S.-h. Chao, Tun-jun TsaiAbstract:A laparoscopic technique was used to rescue dysfunctional Tenckhoff Catheters in five continuous ambulatory peritoneal dialysis (CAPD) patients. This method proved to be effective in recovering the function of the Catheters, whose malfunction was found to be due to Catheter entrapment or endoluminal tamponing by the omentum. The videoscope-assisted laparoscopic technique provides access and allows identification and eradication of the specific etiology leading to Catheter drainage failure. It also provides an alternative for treating patients with a dysfunctional Tenckhoff Catheter. This method avoids the need to remove the original Catheter or to reimplant a new Catheter.
