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Objective: To determine the difference in post-renal transplant lymphocele rate based on the surgical dissection technique for control of lymphatics by examining the historical case group under the direction of a single, university-based surgeon in a retrospective, cohort study., Patients: Five hundred thirty-two consecutive renal transplant patients from January 1994 to December 2009., Findings: Of the 532 cases studied, 259 (48.7%) had suture ligation and 273 (51.3%) employed ultrasonic dissection (UD) for control of lymphatics during renal transplantation. There was no difference found in the rate of lymphocele formation, requiring either percutaneous or surgical drainage, when surgical ties (8.9%) were compared to UD (9.2%; P=.999). Logistic regression analysis showed that the odds ratio for developing a lymphocele was independent of surgical dissection technique. Within the logistic analysis, the prediction for lymphocele was increased 3.29 times for pediatric patients (P=.002) and increased 2.97 times for those who received a living donor graft (P=.001), and there was a trend for those with a history of more than one renal transplant of 2.01 times (P=.079)., Summary: Surgical dissection technique was not a factor in the development of post-renal transplant lymphocele. Younger age, living donor transplant, and repeat transplant status were found to be predictive variables for symptomatic lymphoceles requiring drainage, which may be considered when patients present for posttransplant evaluations for laboratory alterations., (Copyright © 2011 Elsevier Inc. All rights reserved.)

A medical student's fund of knowledge can be assessed by either his demonstrated fund of knowledge on a clinical service or an examination at the completion of the clerkship. During the past 2 years we have evaluated each student's fund of knowledge in two ways: clinical assessment by faculty and residents and performance on the National Board of Medical Examiners Part II Special Surgical Examination given at the end of the surgical clerkship. This study compares the clinical assessment of surgical knowledge for all 100 members of the class of 1984 at the University of Utah with other subjective evaluations such as attitudes and college grade point average and objective measures of performance such as premed MCAT score, Part I National Boards score, and the National Boards Special Surgical Examination. The correlation between clinical assessment of knowledge and the Surgical Examination was 0.23, with a range on individual services from -0.42 to 0.45. There was a higher correlation for the total group of 0.56 between fund of knowledge and attitudes, with a range on individual services of -0.04 to 0.72. The correlations between clinical assessment of knowledge and Part I National Boards, college grade point average, and chemistry MCAT score were 0.23, 0.09, and 0.15, respectively. These results indicate that the clinical assessment of fund of knowledge is not a good predictor of performance on the surgical section of the National Boards. Clinical assessment of fund of knowledge appears to be linked more closely to faculty and resident assessment of student attitudes. There are a couple possible explanations for these results: clinicians are measuring different aspects of knowledge than are National Boards or clinicians do not accurately assess knowledge and confuse attitudes such as interest and enthusiasm with fund of knowledge.