Lymphatic Complications in Renal Transplant: Electrosurgical Unit Versus Ultrasonic Cutting and Coagulation Device

Background: Lymphatic complications, particularly lymphocele, are common after renal transplantation and can adversely affect graft function. Electrosurgical units (ESU) and ultrasonic cutting and coagulation devices (UCCD) are widely used, but their comparative effectiveness in preventing lymphatic leakage remains unclear. Methods: A prospective observational comparative study was conducted over two years at Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia (ABVIMS & Dr. RML) Hospital, New Delhi. Statistical analysis was performed using appropriate tests including the Wilcoxon-Mann-Whitney U test, Fisher’s exact test, and Chi-square test; a p-value <0.05 was considered significant. Twenty donor-recipient pairs were included and alternately assigned to either the ESU group (n=10) or the UCCD group (n=10). Outcomes assessed included intraoperative blood loss, postoperative lymphatic complications, urine output, serum creatinine levels, and the need for additional interventions. Results: The incidence of lymphocele was higher in the ESU group (3/10, 30%) compared to the UCCD group (1/10, 10%), though the difference was not statistically significant (p=0.582). Patients in the ESU group required more postoperative imaging (3/10, 30% vs. 1/10, 10%) and interventions (2/10, 20% vs. 0/10, 0%) for lymphatic complications. No significant differences were observed in renal graft function, as measured by serum creatinine reduction and urine output trends. Conclusions: Both surgical techniques resulted in comparable renal function outcomes; however, the UCCD was associated with a lower incidence of lymphatic complications and fewer postoperative interventions. Larger studies are warranted to validate these findings.