开放性手术治疗重症乳糜尿49例临床分析

Curative Effect of Open Operation for Serious Chyluria:a Report of49Cases

目的评价传统开放性肾蒂淋巴管结扎术临床疗效及目前的地位。方法对49例确诊为重症乳糜尿的患者行开放性肾蒂淋巴管结扎术。结果术后第2天常规尿乳糜定性试验,转阴性41例(84%),仍呈阳性8例(16%),但肉眼下浓度明显降低。约1/3的病人得到随访,乳糜尿消失率为88%,复发率为12%。结论传统开放性肾蒂淋巴管结扎术疗效相当满意。泌尿外科医生应熟练掌握开放性手术技术,并在此基础上逐步开展腔镜下肾蒂淋巴管结扎术。

Objective To evaluate the clinic curative effect and the current status of the traditional open operation, i.e. the renal pedicle lymphatic disconnection, for the serious chyluria. Methods Forty nine cases with serious chyluria underwent the renal pedicle lymphatic disconnection. Results Regular lab test for chyluria was taken on the next day after operation. 41 cases returned negative. 8cases were still positive, but the macroscopic concentration of the chyluria decreased very much. The follow- up （about 1/3 of all cases） showed that the disappearance rate of the chyluria was 88% and the recurrence rate is 12%. Conclusions The curative effect of the renal pedicle lymphatic disconnection operation is satisfactory for chyluria. Urologists should be skilled at the open - operated surgery, and then try out the technique renal pedicle lymphatic vessels with the peritoneoscope.