Comparison Between Bipolar Lymphatic Vessels Cautery and Suture Ligature in Prevention of Postrenal Transplant Lymphocele Formation: A Randomized Controlled Trial.

OBJECTIVES: In this randomized controlled trial, our aim was to compare bipolar cautery of lymphatic vessels with standard silk-tie ligation in renal transplant procedures for prevention of lymphocele formation.

MATERIALS AND METHODS: Sixty end-stage renal disease patients were enrolled in a prospective randomized controlled trial. The mean age of recipients in the suture ligature group was 41.6 years (range, 6-65 years) and 40.9 years in the bipolar cautery group. Patients were assessed by symptoms; however, ultrasonography was also used as the primary diagnostic procedure in all patients to find lymphocele collection within 5 months.

RESULTS: Of 60 patients, 25 received living-donor kidney transplant and 35 received deceased-donor kidney transplant. Fifty-threeprocedures were first-time kidney transplants, 6 were retransplants, and 1 was for a third-time transplant. No lymphocele collection (symptomatic or asymptomatic) was diagnosed by ultrasonography at the 5-month follow-up. Postoperative pain was not significantly different between the 2 groups (P = .245). The time for ligation or cauterization of lymphatic vessels was similar between the 2 groups. Mean duration of operative field drainage was 5.6 days in the suture ligature group and 6.07 days in the bipolar cautery group (not significantly different; P = .547).

CONCLUSIONS: Bipolar cautery of lymphatic vessels to prevent lymphocele formation in kidney transplant seems to be an effective, easy, and safe method.